Individual provider Active NPI

Jessica L. Green, CRNA

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1902103849
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
795190 Issued in TX
Practice address
1000 S Beckham Ave
Department of Anesthesia
Tyler, TX 75701-1908
Phone
(877) 281-9905
Fax
(817) 877-0350
NPI assigned
Feb 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 795190 TX Primary

Addresses

Primary practice location

1000 S Beckham Ave
Department of Anesthesia
Tyler, TX 75701-1908

Mailing address

1000 S Beckham Ave
Department of Anesthesia
Tyler, TX 75701-1908
Phone (877) 281-9905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000360 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557548641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 531-8890

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
795190TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jun 28, 2022 Accepting new patients
East Texas Medical Center Past Accepting new patients

Locations

14425 Falcon Head Blvd
#11
Austin, TX 78738
Phone (512) 900-1006

3080 College St
#T
Beaumont, TX 77701
Phone (409) 212-5002

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

6800 N MacArthur Blvd
Irving, TX 75039
Phone (972) 969-2000

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

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Organizations & group practices 3

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": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1902103849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "877-281-9905",
            "fax_number": "817-877-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "877-281-9905",
            "fax_number": "817-877-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "795190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.