Individual provider Active NPI

Jerica Arunthamakun, P.A.

  • Physician Assistant
  • Katy, TX
National Provider Identifier
1932451747
Registry record updated Dec 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1331 W Grand Pkwy N
Suite #203
Katy, TX 77493-2710
Phone
(281) 392-8620
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2014

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 TX Primary
Physician Assistant 363A00000X TN

Addresses

Primary practice location

1331 W Grand Pkwy N
Suite #203
Katy, TX 77493-2710

Mailing address

3120 Parkway
Pigeon Forge, TN 37863-3310

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
I20150205000748 TX Practitioner - Physician Assistant 3971828344 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417910400000",
    "number": "1932451747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 PARKWAY",
            "city": "PIGEON FORGE",
            "state": "TN",
            "postal_code": "378633310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W GRAND PKWY N",
            "address_2": "SUITE #203",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932710",
            "telephone_number": "281-392-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARUNTHAMAKUN",
        "first_name": "JERICA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2014-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.