Individual provider Active NPI

Vivek Menon, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Lufkin, TX
National Provider Identifier
1073889622
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
U5166 Issued in TX
Practice address
310 Gaslight Blvd
Lufkin, TX 75904-3133
Phone
(936) 632-8787
NPI assigned
Mar 28, 2012
Last updated
May 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56984587 GA
Cardiovascular Disease Physician 207RC0000X U5166 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X U5166 TX Primary

Addresses

Primary practice location

310 Gaslight Blvd
Lufkin, TX 75904-3133

Mailing address

9500 Euclid Ave
Mail Code: M75
Cleveland, OH 44195-0001
Phone (216) 636-7563

Other practice location 1

9500 Euclid Ave
Mail code: M75
Cleveland, OH 44195-0001
Phone (216) 636-7563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210827000590 MS Practitioner - Internal Medicine 1658652862 Reassigns benefits to 3 organizations
I20250527000120 TX Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 1658652862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

17350 St Lukes Way
Suite 400
The Woodlands, TX 77384-4167
Phone (281) 444-3278

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56984587GAMDInternal Medicine Physician
U5166TXMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Magnolia Hospitalist Group CurrentSince Oct 1, 2022 Accepting new patients
Tishomingo Health Services, Inc. CurrentSince Jun 21, 2022 Accepting new patients
Tishomingo Health Services, Inc. CurrentSince Jun 21, 2022 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Oct 1, 2022 Accepting new patients
Baylor St. Luke's Medical Group Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

951 E Loop 304
Crockett, TX 75835
Phone (936) 545-9030

1 Baylor Plz
#2
Houston, TX 77030

20207 Chasewood Park Dr
Ste 300
Houston, TX 77070
Phone (832) 534-7800

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

208 Craig St
Jasper, TX 75951
Phone (409) 383-6044

1717 Highway 59 Loop N
Ste B
Livingston, TX 77352
Phone (936) 327-7733

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

310 Gaslight Blvd
Lufkin, TX 75904

1300 N Mound St
Nacogdoches, TX 75961
Phone (409) 560-2990

17198 St Lukes Way
Ste 440
The Woodlands, TX 77384
Phone (936) 266-2500

17350 St Lukes Way
Ste 400
The Woodlands, TX 77384
Phone (832) 249-3721

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
  • Direct secure messaging: menon.vivek.p1@direct.hiet.nextgenshare.com
  • Direct secure messaging: vivekmenon@magnolia.medalliesdirect.net
  • Direct secure messaging: vivekmenon@nmhs.medalliesdirect.net

Organizations & group practices 11

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 3

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1073889622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "MAIL CODE: M75",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-636-7563",
            "fax_number": "216-636-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_2": "Mail code: M75",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-636-7563",
            "fax_number": "216-636-5390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENON",
        "first_name": "VIVEK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "56984587",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "U5166",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "U5166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.