Individual provider Active NPI

Poovamma B Muthappa, MD

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
National Provider Identifier
1063550374
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
H5596 Issued in TX
Practice address
14027 Memorial Dr # 252
Houston, TX 77079
Phone
(281) 412-2494
Fax
(281) 412-2495
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X H5596 TX Primary

Addresses

Primary practice location

14027 Memorial Dr # 252
Houston, TX 77079

Mailing address

14207 Memorial Dr. Ste 252
Houston, TX 77079
Phone (832) 203-7640

Other identifiers 1

IdentifierTypeStateIssuer
126236203MedicaidTX

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
I20180711000226 TX Practitioner - Pediatric Medicine 8224384987 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Apr 5, 2018 Accepting new patients
Ut Physicians CurrentSince Apr 5, 2018 Accepting new patients
Memorial-Spring Branch Neonatology Consultants, P.a. Neonatal-Perinatal Medicine Past Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1063550374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14207 MEMORIAL DR. STE 252",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77079",
            "telephone_number": "832-203-7640",
            "fax_number": "832-834-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14027 MEMORIAL DR # 252",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77079",
            "telephone_number": "281-412-2494",
            "fax_number": "281-412-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHAPPA",
        "first_name": "POOVAMMA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "H5596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126236203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.