Individual provider Active NPI

Jennifer Nicole Tellez, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1861639379
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
687374 Issued in TX
Practice address
2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone
(713) 620-4000
NPI assigned
Jan 21, 2009
Last updated
Sep 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 687374 TX
Certified Registered Nurse Anesthetist 367500000X 687374 TX Primary

Addresses

Primary practice location

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817

Mailing address

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone (713) 620-4000

Other identifiers 3

IdentifierTypeStateIssuer
205627704MedicaidTX
205627703MedicaidTX
8486UBOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090424000295 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628126935 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texans Anesthesia Associates PLLCGroup PAC ID 8820171390, 197 clinicians

Practice addresses (Care Compare)

15300 Southwest Fwy
Suite 100
Sugar Land, TX 77478-3827
Phone (281) 274-6670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Practitioner CurrentSince Apr 12, 2011 Accepting new patients
Texans Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2015 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Practitioner CurrentSince Apr 12, 2011 Accepting new patients
Northstar Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 2, 2009 Accepting new patients

Locations

2000 E Lamar Blvd
Ste 400
Arlington, TX 76006
Phone (817) 861-3994

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

909 9th Ave
Ft Worth, TX 76104
Phone (817) 336-6060

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

2411 Fountain View Dr
Ste 200
Houston, TX 77057
Phone (713) 458-4185

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

7700 Fannin St
Houston, TX 77054
Phone (713) 790-1349

9525 Katy Fwy
Ste 206
Houston, TX 77024
Phone (713) 400-2993

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

15300 Southwest Fwy
Ste 100
Sugar Land, TX 77478
Phone (281) 274-6670

333 N Texas Ave
Ste 1000
Webster, TX 77598
Phone (281) 557-5620

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1861639379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "687374",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "687374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205627704",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205627703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8486UB",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.