1. Home
  2. Directory
  3. Texas
  4. Willow Park
  5. Pediatrics
  6. NPI Profile

JENICA M ROSE-STINE DO
NPI 1174735872
Pediatrics in Willow Park, TX

Active since May 04, 2007PECOS Enrolled
136 EL CHICO TRL STE 102, WILLOW PARK, TX 76087(817) 441-5412(817) 441-9354 Get Directions Write a Review

NPPES record last updated: April 19, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 19, 2021, Apr 9, 2021, May 11, 2016 (3 updates tracked since 2016).

About Jenica M Rose-stine Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENICA M ROSE-STINE DO (NPI 1174735872) is an individual pediatrics provider in Willow Park, Texas, licensed in Texas (M8294) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174735872
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJENICA M ROSE-STINECredential: DO
Location Address136 EL CHICO TRL STE 102Willow Park, TX 76087-8864
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855 · Fax (682) 885-1396
Phone(817) 441-5412
Fax(817) 441-9354
Sole ProprietorNo
Enumeration DateMay 4, 2007
Last NPPES UpdateApril 19, 20213 updates tracked since enumeration
NPPES CertifiedApril 19, 2021
✔ NPI 1174735872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · M8294
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
136 EL CHICO TRL STE 102, Willow Park, TX 76087
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenica M Rose-stine Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jenica Rose-stine reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cook Children's Physician Network
17 mi
Developmental - Behavioral Pediatrics
1500 COOPER ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Cook Childrens Physician Network
  • 1,186 clinicians in this Medicare group
NPI 1548230923 (682) 303-9200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76087 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEE SKRHAK CPNP-PC
Nurse Practitioner (Primary Care)
136 EL CHICO TRL STE 102
WILLOW PARK, TX 76087
Parker County (817) 441-5412
ASHLEY MCLAUGHLIN
Nurse Practitioner (Primary Care)
136 EL CHICO TRL STE 102
WILLOW PARK, TX 76087
Parker County (817) 441-5412
MRS. ASHLEY MARIE WALDROP PA
Physician Assistant
136 EL CHICO TRL STE 102
WILLOW PARK, TX 76087
Parker County (817) 441-5412
TARA N HARALDSON PNP
Nurse Practitioner (Primary Care)
136 EL CHICO TRL STE 102
WILLOW PARK, TX 76087
Parker County (817) 441-5412

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jenica Rose-stine's NPI number?

The NPI number for Jenica Rose-stine is 1174735872. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Where is Jenica Rose-stine located?

Jenica Rose-stine practices at 136 El Chico Trl Ste 102, Willow Park, TX 76087. The listed phone number is (817) 441-5412.

What is Jenica Rose-stine's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jenica Rose-stine enrolled in Medicare?

Yes. Jenica Rose-stine is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jenica Rose-stine's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenica Rose-stine reassigns Medicare benefits to Cook Children's Physician Network (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jenica Rose-stine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jenica Rose-stine was last updated on April 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.