Individual provider Active NPI

Nagendra S Kodali, M.D.

  • Pediatric Anesthesiology Physician
  • Houston, TX
National Provider Identifier
1063573103
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
Q1650 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2358
Phone
(832) 824-1000
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Q1650 TX
Pediatric Anesthesiology Physician 207LP3000X 058535 GA
Pediatric Anesthesiology Physician 207LP3000X Q1650 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2358

Mailing address

6621 Fannin St Ste W17417
Houston, TX 77030-2372
Phone (832) 824-1000

Other practice location 1

6606 Lbj Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 715-5000

Other identifiers 2

IdentifierTypeStateIssuer
342414501MedicaidTX
8ET177OtherTXBCBS TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20070213000537 GA Practitioner - Anesthesiology 3274535778 Reassigns benefits to 1 organization
I20100927000641 TN Practitioner - Anesthesiology 3274535778 Reassigns benefits to 1 organization
I20141111002200 TX Practitioner - Anesthesiology 3274535778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1993
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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q1650TXMDAnesthesiology Physician
058535GAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jan 1, 2007 Accepting new patients
Pediatric Anesthesiologists P a Anesthesiology CurrentSince Aug 1, 2010 Accepting new patients
Texas Children'S Physician Group CurrentSince May 4, 2016 Accepting new patients
Pediatric Anesthesiologists PA Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

50 N Dunlap St
Memphis, TN 38103
Phone (901) 522-3060

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

6621 Fannin St
Ste W17417
Houston, TX 77030

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

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

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

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

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

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.

Hospital & facility affiliations 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1063573103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE W17417",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302372",
            "telephone_number": "832-824-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302358",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6606 Lbj Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752406524",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODALI",
        "first_name": "NAGENDRA S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q1650",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "GA",
            "license": "058535",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "Q1650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342414501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8ET177",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.