MS. MIRANDA JALENE POOL (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1649425091
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for MS. MIRANDA JALENE POOL (PHYSICIAN ASSISTANT)
17819 RED RIVER CANYON DR
HUMBLE, TX 773463543
Phone: (832) 810-0200
Fax: (888) 682-7273
Type: Mailing
706, Old Montgomery Road, Conroe, Montgomery County, Texas, 77301, United States
CONROE, TX 773012740
Phone: (936) 538-1150
Type: Location
676 FM 517 RD W
DICKINSON, TX 775393904
Phone:
Type: Mailing
1300 SOUTH DRIVE
WINNEBAGO, WI 549855498
Phone: (920) 235-4910
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-05-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151102001150 | I | Physician Assistant | TX | TBD |
| I20250516000215 | I | Physician Assistant | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77346)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | TN | |
| Nurse Practitioner | TN | |
| Physician Assistant | MO | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Internal Medicine | TN | |
| Nurse Practitioner | TN | |
| Hospitalist, Internal Medicine | NY | |
| Nurse Practitioner | TN | |
| Physician Assistant | GA |
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