NPIMap

Individual provider Active NPI

Ajith Kuriakose, MD

  • Nephrology Physician
  • Beaumont, TX
National Provider Identifier
1073772224
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N1718 Issued in TX
Practice address
710 S 8TH St Ste a
Beaumont, TX 77701-4680
Phone
(409) 212-9240
Fax
(409) 212-9239
NPI assigned
Jun 3, 2008
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N1718 TX
Nephrology Physician 207RN0300X N1718 TX Primary

Addresses

Primary practice location

710 S 8TH St Ste a
Beaumont, TX 77701-4680

Mailing address

710 S 8TH St Ste a
Beaumont, TX 77701-4680
Phone (409) 212-9240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000925 TX Practitioner - NephrologyPractitioner - Internal Medicine 7719044528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

710 S 8TH St
Suite a
Beaumont, TX 77701-4680
Phone (409) 212-9240

930 Marvin Hancock Dr
RM a
Jasper, TX 75951-4752
Phone (409) 212-9240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1718TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Nephrology Associates Nephrology CurrentSince Jun 10, 2012 Accepting new patients
Beaumont Nephrology Associates Nephrology CurrentSince Jun 10, 2012 Accepting new patients
Texas Kidney Associates MD PA Internal Medicine CurrentSince Aug 27, 2011 Accepting new patients
Beaumont Nephrology Associates Nephrology Past Accepting new patients
Mercy Hospital Grayling Past Accepting new patients
Quantum Hospital Medicine Services of Texas PA Internal Medicine Past Accepting new patients

Locations

2955 Harrison Ave
Ste 100
Beaumont, TX 77702
Phone (409) 212-9240

710 S 8th St
Ste A
Beaumont, TX 77701
Phone (409) 212-9240

100 Medical Center Blvd
Ste 116
Conroe, TX 77304
Phone (936) 225-4222

1500 Grand Lake Dr
Conroe, TX 77304
Phone (866) 480-0480

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

607 Timberdale Ln
Ste 100
Houston, TX 77090
Phone (281) 880-7066

930 Marvin Hancock Dr
Rm A
Jasper, TX 75951
Phone (409) 212-9240

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEBBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEBBD/Endpoint/HAEBBD

Organizations & group practices 6

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 9

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1073772224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S 8TH ST STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014680",
            "telephone_number": "409-212-9240",
            "fax_number": "409-212-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S 8TH ST STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014680",
            "telephone_number": "409-212-9240",
            "fax_number": "409-212-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "AJITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1718",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N1718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.