JACK MONCRIEF GROUP, PA (NPI# 1194053496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194053496 |
| Entity Type | Organization |
| Organization Name | JACK MONCRIEF GROUP, PA |
| Practice Address |
800 West 34th Street Suite 101 Austin TX 78705 |
| Practice Telephone | 5124857870 |
| Practice Fax Number | 5124857876 |
| Mailing Telephone | 5124857870 |
| Mailing Fax Number | 5124857876 |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |
| Authorized Official Name | DR. JACK WESLY MONCRIEF (OWNER) |
| Authorized Official Telephone | 5124857870 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1311987-04 | 05 |
| Street Address |
800 WEST 34TH STREET SUITE 101 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894559 | Ben Aviel | Specialist/Technologist | 2501 Leon, Austin, TX 78705 | 2020-08-31 |
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1952941155 | Oluwakemi Yemi-ese | Counselor | 2717 Rio Grande Street, Austin, TX 78705 | 2020-01-15 |
| 1285272765 | Lisa K Wheeler | Counselor | 2520 Longivew Street, Suite 313, Austin, TX 78705 | 2019-12-16 |
| 1033767637 | Olivia May Neel | Specialist/Technologist | 620 West 24th Street, 208a, Austin, TX 78705 | 2019-08-28 |
| 1336795202 | Grace Evelyn Martin | Specialist/Technologist | University of Texas, 110 Inner Campus Drive, Austin, TX 78705 | 2019-08-15 |
| 1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
| 1124502794 | Joan Margaret Carroll | Physician Assistant | 3000 N, I-35, Suite 600, Austin, TX 78705 | 2018-09-19 |
| 1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
| 1740707892 | Christine Marie Falk | Specialist/Technologist | 2810 Hemphill Park, Apt 211, Austin, TX 78705 | 2017-08-29 |
| Find all providers in zip 78705 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770775728 | Kartik Pillutla | Pediatrics | 1301 Barbara Jordan Blvd, Suite #200, Austin, TX 78723-3077 | 2007-08-14 |
| 1386678993 | David H. Simon | Pediatrics | 1301 Barbara Jordan Blvd Ste 200, Austin, TX 78723-3078 | 2006-07-10 |
| 1568428571 | Phillip L. Berry | Pediatrics | 1301 Barbara Jordan Blvd Ste 200, Austin, TX 78723-3078 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265859755 | Peace Dorothy Imani | Pediatrics | 1102 Bates Ave., Baylor College of Medicine, Houston, Tx, TX 77030 | 2014-03-24 |
| 1356762256 | L. L. Hill | Pediatrics | 4906 Tilbury, Houston, TX 77056-2214 | 2013-12-18 |
| 1154640324 | Khurrum Siddique | Pediatrics | 2821 Michaelangelo Dr Ste 101, Edinburg, TX 78539-1411 | 2010-05-26 |
| 1922272236 | Alvaro Hernando Orjuela | Pediatrics | 1102 Bates Ave Ste 260, Houston, TX 77030-2619 | 2008-04-17 |
| 1417157215 | Catherine Joseph | Pediatrics | 1102 Bates Ave Ste 245, Houston, TX 77030-2619 | 2007-07-19 |
| 1003916172 | Jose F Pascual-baralt | Pediatrics | 7419 Round Mtn, San Antonio, TX 78255-1159 | 2006-09-25 |
| 1962519033 | Mazen Arar | Pediatrics | 333 N Santa Rosa, 2nd Fl, San Antonio, TX 78207 | 2006-08-24 |
| 1376905596 | Caroline Elizabeth Jarrell | Pediatrics | 6701 Fannin St, Houston, TX 77030-2608 | 2016-03-26 |
| 1093154379 | Ali Kareem Kurady | Pediatrics | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2013-06-19 |
| 1427497163 | Bandana Paudyal-nepal | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2013-06-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.