Individual provider Active NPI

Jack Kasey Carter

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1891343844
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA13337 Issued in TX
Practice address
7401 Main St
Houston, TX 77030-4509
Phone
(771) 379-9230
Fax
(713) 794-3380
NPI assigned
Sep 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA13337 TX Primary

Addresses

Primary practice location

7401 Main St
Houston, TX 77030-4509

Mailing address

7401 Main St
Houston, TX 77030-4509
Phone (713) 799-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200221000674 TX Practitioner - Physician Assistant 6901233568 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

2635 W Baker Rd
Baytown, TX 77521-2206
Phone (281) 337-8550

7401 Main St
Houston, TX 77030-4509
Phone (713) 799-2300

7718 Garth Rd
Baytown, TX 77521-2206
Phone (713) 347-9031

Hospital & facility affiliations

  • Texas Orthopedic Hospital Hospital, Houston, TX, CCN 450804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13337TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Mar 22, 2021 Accepting new patients
Ortholonestar, PLLC CurrentSince Mar 22, 2021 Accepting new patients
Fondren Orthopedic Group LLP CurrentSince Mar 22, 2021 Accepting new patients
Ortholonestar, PLLC Past Accepting new patients

Locations

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

18220 Tomball Pkwy
Ste 330
Houston, TX 77070
Phone (281) 477-6192

7401 Main St
Houston, TX 77030
Phone (713) 799-8600

Interoperability endpoints

  • Direct secure messaging: jack.carter.1@15533.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1891343844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304509",
            "telephone_number": "713-799-2300",
            "fax_number": "713-794-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304509",
            "telephone_number": "771-379-9230",
            "fax_number": "713-794-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JACK",
        "middle_name": "KASEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA13337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.