Individual provider Active NPI

Jofy S Kuriakose

  • Nurse Practitioner
  • Plano, TX
National Provider Identifier
1912142977
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP117061 Issued in TX
Practice address
3300 Dallas Pkwy Ste 224
Plano, TX 75093-7771
Phone
(972) 573-3157
Fax
(855) 828-0878
NPI assigned
Dec 4, 2008
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 AP117061 TX Primary
Family Nurse Practitioner 363LF0000X 760576 TX

Addresses

Primary practice location

3300 Dallas Pkwy Ste 224
Plano, TX 75093-7771

Mailing address

5929 Balcones Dr Ste 200
Austin, TX 78731-4280
Phone (512) 550-1800

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
I20090117000075 TX Practitioner - Nurse Practitioner 8426111402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Sinus and Allergy Specialists of TexasGroup PAC ID 7315169596, 41 clinicians

Practice addresses (Care Compare)

115 N Loop 1604 E
1204 Texan Allergy
San Antonio, TX 78232-1399
Phone (512) 550-1800

3001 Knox St
Suite 407
Dallas, TX 75205-5594
Phone (512) 550-1800

7125 New Sanger Ave
504 Texan Allergy
Waco, TX 76712-4054
Phone (512) 550-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP117061TXMDNurse Practitioner
760576TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Texas PLLC Family CurrentSince Aug 3, 2010 Accepting new patients
Sinus & Allergy Specialists of Texas CurrentSince Jan 7, 2017 Accepting new patients
Minuteclinic Diagnostic of Texas PLLC CurrentSince Aug 3, 2010 Accepting new patients
Noble Anesthesia Partners, PLLC PastSince Oct 30, 2022 Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5929 Balcones Dr
Ste 200
Austin, TX 78731
Phone (512) 222-5856

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

3001 Knox St
Ste 407
Dallas, TX 75205

1650 W Northwest Hwy
Ste 202
Grapevine, TX 76051
Phone (817) 552-0252

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

3300 Dallas Pkwy
Ste 224
Plano, TX 75093
Phone (469) 297-9579

115 N Loop 1604 E
Ste 1204
San Antonio, TX 78232
Phone (210) 446-0418

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1912142977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 BALCONES DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314280",
            "telephone_number": "512-550-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 DALLAS PKWY STE 224",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937771",
            "telephone_number": "972-573-3157",
            "fax_number": "855-828-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "JOFY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP117061",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "760576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.