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JASMINE S PENDERGRASS
NPI 1376002105
Pediatrics in Houston, TX

Active since March 19, 2019PECOS Enrolled
1504 TAUB LOOP, HOUSTON, TX 77030(713) 798-1750(713) 798-4693 Get Directions Write a Review

NPPES record last updated: September 26, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 26, 2022, May 20, 2022, Mar 19, 2019 (3 updates tracked since 2019).

About Jasmine S Pendergrass NPPES

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

JASMINE S PENDERGRASS (NPI 1376002105) is an individual pediatrics provider in Houston, Texas, licensed in Texas (T6350) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Houston.

NPPES Registry Identity

NPI1376002105
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJASMINE S PENDERGRASS
Location Address1504 TAUB LOOPHouston, TX 77030-1608
Mailing Address1504 Taub LoopHouston, TX 77030-1608 · (713) 798-1750 · Fax (713) 798-4693
Phone(713) 798-1750
Fax(713) 798-4693
Sole ProprietorNo
Enumeration DateMarch 19, 2019
Last NPPES UpdateSeptember 26, 20223 updates tracked since enumeration
NPPES CertifiedJune 5, 2022
✔ NPI 1376002105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · T6350
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.
1504 TAUB LOOP, Houston, TX 77030
Open in Google Maps ↗

Secondary Practice Location 1

Location 11 Baylor Plz # Bcm320Houston, TX 77030-3411 · Phone (832) 824-1170

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jasmine S Pendergrass 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 Jasmine Pendergrass reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baylor College Of Medicine
Same address
Family Medicine
1504 TAUB LOOP
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • 2,296 clinicians in this Medicare group
NPI 1053352914 (713) 873-2000

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 77030 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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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 20

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

ZAVEN SARGSYAN MD
Internal Medicine
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 873-8890
KAYE-ANN ANTONETTE CHRISTIE PA-C
Physician Assistant
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 873-2000
EMILY MARIE WEBSTER PA-C
Physician Assistant
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 873-8890
DR. MIGUEL A NIETO D.O.
Emergency Medicine
1504 TAUB LOOP, EMERGENCY CENTER
HOUSTON, TX 77030
Harris County (713) 873-7045
DR. LOUIS BRUNO FORNAGE MD
Emergency Medicine
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 873-3060
DR. MICHELE TROUTMAN GIFFORD MD
Obstetrics & Gynecology
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 798-1750
DR. KYLE SUEN M.D.
Emergency Medicine
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (713) 873-8890
DR. MIYSHA SHAW GIRARDEAU MD, MS
Internal Medicine
1504 TAUB LOOP
HOUSTON, TX 77030
Harris County (771) 387-3889

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 Jasmine Pendergrass's NPI number?

The NPI number for Jasmine Pendergrass is 1376002105. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Where is Jasmine Pendergrass located?

Jasmine Pendergrass practices at 1504 Taub Loop, Houston, TX 77030. The listed phone number is (713) 798-1750.

What is Jasmine Pendergrass's specialty?

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

Is Jasmine Pendergrass enrolled in Medicare?

Yes. Jasmine Pendergrass is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jasmine Pendergrass's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jasmine Pendergrass reassigns Medicare benefits to Baylor College Of Medicine (Houston, 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 Jasmine Pendergrass'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 Jasmine Pendergrass was last updated on September 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.