Individual provider Active NPI

Aimee Gretchen Kakascik, D.O.

  • Pediatric Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1053518589
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
M9392 Issued in TX
Practice address
6621 Fannin St Ste 310
MC 2-1495
Houston, TX 77030-2303
Phone
(832) 824-5900
Fax
(832) 825-5905
NPI assigned
Jun 28, 2007
Last updated
May 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X M9392 TX Primary
Anesthesiology Physician 207L00000X 19731 MS

Addresses

Primary practice location

6621 Fannin St Ste 310
MC 2-1495
Houston, TX 77030-2303

Mailing address

6621 Fannin St Ste 310
MC 2-1495
Houston, TX 77030-2303
Phone (832) 824-5900

Other identifiers 1

IdentifierTypeStateIssuer
T1650OtherMSMEDICAL LICENSE NUMBER

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
I20081023000327 TX Practitioner - Anesthesiology 3375601180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19731MSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group CurrentSince Oct 1, 2008 Accepting new patients

Locations

2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
Ste 310
Houston, TX 77030
Phone (832) 824-5809

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1053518589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE 310",
            "address_2": "MC 2-1495",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5900",
            "fax_number": "832-825-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE 310",
            "address_2": "MC 2-1495",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5900",
            "fax_number": "832-825-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKASCIK",
        "first_name": "AIMEE",
        "middle_name": "GRETCHEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "M9392",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "19731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "T1650",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.