Individual provider Active NPI

Shahnaz Amyn Jiwani, FNP-C

  • Family Nurse Practitioner
  • League City, TX
National Provider Identifier
1922676949
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1036834 Issued in TX
Practice address
2240 Gulf Fwy S
League City, TX 77573-5143
Phone
(832) 505-1234
NPI assigned
Jun 15, 2021
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1036834 TX Primary

Addresses

Primary practice location

2240 Gulf Fwy S
League City, TX 77573-5143

Mailing address

PO Box 650859 Dept 710
Dallas, TX 75265-7064
Phone (409) 772-0620

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
I20211020000543 TX Practitioner - Nurse Practitioner 3577951854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2240 Gulf Fwy S
Suite 3.704
League City, TX 77573-5143
Phone (832) 505-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1036834TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Oct 1, 2021 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

2240 Gulf Fwy S
Ste 3704
League City, TX 77573
Phone (832) 505-1234

17448 Highway 3
Ste 200
Webster, TX 77598
Phone (832) 505-1748

Interoperability endpoints

  • Direct secure messaging: sjiwani46044@direct.utmb.edu

Organizations & group practices 2

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.

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1922676949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859 DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752657064",
            "telephone_number": "409-772-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GULF FWY S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735143",
            "telephone_number": "832-505-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIWANI",
        "first_name": "SHAHNAZ",
        "middle_name": "AMYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1036834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.