Active NPI 1174905384 Individual Practitioner Male Practitioner

Justin James Cummings

Nurse Practitioner • Tomball, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Justin Cummings is a certified Nurse Practitioner practicing in Tomball, TX. With approximately 12 years of clinical experience since completing medical education in 2014, Justin Cummings delivers high-quality medical care to the local community at 506 GRAHAM DRIVE.

Justin Cummings is affiliated with Physicians Referral Service and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

506 Graham Drive
Suite 290

Tomball, TX 77375

Telephone 2813571934

Fax 2813571230

Associated Practice Facility / Clinic

🏢 Texas Gastro Consultants, P.a. Facility NPI 1740252550

Medicare Profile & Education

Medical School

Other

Graduation Year

2014

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Tomball, TX

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

12 Yrs +1.6 yrs vs City Avg

City Avg: 10.4 Yrs

State Avg: 9.7 Yrs

Regional Practice Density

17 Specialists

Practicing in Tomball, TX (4894 Statewide)

Telehealth Adoption Rate

11.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

71.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Cummings (12 Years) 12 Yrs

Tomball Specialty Average (10.4 Years) 10.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	157	108	$276.90	$78.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	60	51	$557.40	$116.62
99443 Telephone medical discussion with physician, 21-30 minutes	40	36	$274.48	$100.02
99442 Telephone medical discussion with physician, 11-20 minutes	26	24	$176.62	$73.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	101	63	$533.46	$116.98
99443 Telephone medical discussion with physician, 21-30 minutes	59	48	$265.22	$79.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	47	40	$268.38	$79.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	68	51	$517.50	$119.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	47	39	$253.81	$80.08
99443 Telephone medical discussion with physician, 21-30 minutes	31	27	$258.45	$80.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	73	60	$157.15	$55.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	69	58	$247.74	$82.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	174	145	$235.28	$65.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	138	99	$231.32	$65.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	35	33	$225.00	$67.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	94	79	$225.00	$67.08
99213 Established patient office or other outpatient visit, typically 15 minutes	16	16	$144.02	$44.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	98	83	$225.00	$65.86
99213 Established patient office or other outpatient visit, typically 15 minutes	55	49	$144.00	$43.86

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License TX AP128197

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Aprn

AP128197 (TX)

Hospital & Practice Group Affiliations

Physicians Referral Service

2130 W Holcombe Blvd, Houston, TX 770304009

Phone: 7135925433

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Michael Casagrande , MD

Family Medicine

NPI 1427163955

Doctor of Medicine (M.D.)

Megan Ryan , FNP

Nurse Practitioner

NPI 1528566098

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active June 24, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location June 24, 2015

Registered at 506 GRAHAM DRIVE, SUITE 290, TOMBALL, TX 77375 (Tel: 2813571934)

📍

Updated Business Mailing Address June 24, 2015

Registered at 506 GRAHAM DRIVE, SUITE 290, TOMBALL, TX 77375 (Tel: 2813571934)

👤

Provider Name / Credentials Updated June 24, 2015

Recorded as JUSTIN CUMMINGS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2015

Nurse Practitioner (License #AP128197 in TX)

🟢

Initial NPI Registration & Enumeration June 24, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174905384

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 24, 2015

Last Update: June 24, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

506 Graham Drive, Suite 290

Tomball, TX 77375

Phone: 2813571934

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.