Individual provider Active NPI

Kiranchandra Maganlal Patel, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1053416453
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K6680 Issued in TX
Practice address
15419 Rocky Oak CT
Houston, TX 77059-3128
Phone
(713) 436-9800
Fax
(713) 436-5551
NPI assigned
Sep 13, 2006
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K6680 TX Primary

Addresses

Primary practice location

15419 Rocky Oak CT
Houston, TX 77059-3128

Mailing address

9235 Katy Fwy
Ste 400
Houston, TX 77024-1507
Phone (713) 461-2915

Other identifiers 1

IdentifierTypeStateIssuer
043657804MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100802000949 TX Practitioner - Family PracticePractitioner - General Practice 8527191246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Fort Wayne College of Medicine - NLG, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

6122 Broadway St
Suite 100
Pearland, TX 77581-7804
Phone (346) 398-7252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Practice, L.L.P Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Villagemd of Southeast Texas, PA Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Texas Gulf Coast Medical System, Inc Family Medicine Past Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients

Locations

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

9235 Katy Fwy
Ste 400
Houston, TX 77024
Phone (346) 980-2701

9055 Katy Fwy
Ste 200
Houston, TX 77024
Phone (346) 980-2701

6122 Broadway St
#100
Pearland, TX 77581
Phone (346) 398-7252

6122 Broadway St
Ste 100
Pearland, TX 77581

Interoperability endpoints

  • Direct secure messaging: kiranchandra.patel.1@13711.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1053416453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9235 KATY FWY",
            "address_2": "STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241507",
            "telephone_number": "713-461-2915",
            "fax_number": "713-932-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15419 ROCKY OAK CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770593128",
            "telephone_number": "713-436-9800",
            "fax_number": "713-436-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KIRANCHANDRA",
        "middle_name": "MAGANLAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043657804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.