Individual provider Active NPI

Dominic Maliakkal Joseph, MDPA

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1073559159
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J1278 Issued in TX
Practice address
9401 Southwest Fwy
Houston, TX 77074-1407
Phone
(713) 970-3354
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J1278 TX Primary

Addresses

Primary practice location

9401 Southwest Fwy
Houston, TX 77074-1407

Mailing address

2026 Valleria CT
Sugar Land, TX 77479-5568
Phone (281) 265-8056

Other practice location 1

1331 S Grand Pkwy
320
Katy, TX 77494-8288
Phone (281) 540-9473

Other identifiers 6

IdentifierTypeStateIssuer
131226606MedicaidTX
131226605MedicaidTX
260044914OtherTXRAIL ROAD
131226604MedicaidTX
260044915OtherTXRAIL ROAD
89406SOtherTXBLUE CROSS BLUE SHIELD

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
I20040617000720 TX Practitioner - Psychiatry 7416931233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
The Harris Center for Mental Health and IddGroup PAC ID 9739088790, 122 clinicians

Practice addresses (Care Compare)

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 970-7000

9401 Southwest Fwy
Houston, TX 77074-1407

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
78.41
Improvement activities
40
Cost
77.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J1278TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Harris Center for Mental Health and Idd CurrentSince Sep 20, 2020 Accepting new patients
Dominic M. Joseph Mdpa Psychiatry PastSince Jul 5, 2013 Accepting new patients
The Harris Center for Mental Health and Idd PastSince Jan 1, 1990 Accepting new patients

Locations

9401 Southwest Fwy
Houston, TX 77074
Phone (713) 970-3344

7011 Southwest Fwy
Houston, TX 77074
Phone (713) 970-3454

3737 Dacoma St
Houston, TX 77092
Phone (713) 970-8400

1502 Taub Loop
Houston, TX 77030
Phone (713) 873-4900

Organizations & group practices 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1073559159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 VALLERIA CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795568",
            "telephone_number": "281-265-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-3354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 S Grand Pkwy",
            "address_2": "320",
            "address_purpose": "LOCATION",
            "city": "Katy",
            "state": "TX",
            "postal_code": "774948288",
            "country_code": "US",
            "telephone_number": "281-540-9473",
            "fax_number": "281-265-2761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DOMINIC",
        "middle_name": "MALIAKKAL",
        "name_prefix": "Dr.",
        "credential": "MDPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J1278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131226606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131226605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "260044914",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131226604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "260044915",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89406S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.