NPIMap

Individual provider Active NPI

Rosemary Drysdale Bouse, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1962776377
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2636 S Loop W
Suite 105
Houston, TX 77054-2680
Phone
(832) 834-3800
NPI assigned
Mar 2, 2012
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

2636 S Loop W
Suite 105
Houston, TX 77054-2680

Mailing address

2636 S Loop W
Suite 105
Houston, TX 77054-2680
Phone (832) 834-3800

Other identifiers 1

IdentifierTypeStateIssuer
3232126MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000675 TX Practitioner - Physician Assistant 8325281041 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

20171 Chasewood Park Dr
Houston, TX 77070-1437
Phone (832) 534-5000

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Physician Assistant CurrentSince Dec 5, 2022 Accepting new patients
Ut Physicians CurrentSince Dec 5, 2022 Accepting new patients
Rhonda Barnes Jordan, MD PA Past Accepting new patients
The Wellness Doc Integrative Medicine, PLLC PastSince Mar 5, 2023 Accepting new patients

Locations

20171 Chasewood Park Dr
#H
Houston, TX 77070
Phone (832) 534-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

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

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1962776377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 S LOOP W",
            "address_2": "SUITE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542680",
            "telephone_number": "832-834-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 S LOOP W",
            "address_2": "SUITE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542680",
            "telephone_number": "832-834-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSE",
        "first_name": "ROSEMARY",
        "middle_name": "DRYSDALE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3232126",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.