Individual provider Active NPI

Grzegorz P Kurzydlo, M.D., P.A.

  • Neurology Physician
  • Humble, TX
National Provider Identifier
1083611925
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
L7790 Issued in TX
Practice address
19411 McKay Dr
Ste 200
Humble, TX 77338-5722
Phone
(281) 570-4112
Fax
(281) 570-4067
NPI assigned
Jul 7, 2005
Last updated
Nov 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X L7790 TX Primary

Addresses

Primary practice location

19411 McKay Dr
Ste 200
Humble, TX 77338-5722

Mailing address

19411 McKay Dr
Ste 200
Humble, TX 77338-5722
Phone (281) 570-4112

Other identifiers 2

IdentifierTypeStateIssuer
164768701MedicaidTX
7946539OtherTXAETNA

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
I20040206000887 TX Practitioner - NeurologyPractitioner - Internal Medicine 4880587369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19411 McKay Dr
Suite 200
Humble, TX 77338-5722
Phone (281) 570-4112

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Matters PLLC Neurology CurrentSince Jan 8, 2021 Accepting new patients
Psych Matters PLLC Neurology CurrentSince Jan 8, 2021 Accepting new patients
Grzegorz Kurzydlo, M.D., P.a. Neurology CurrentSince Aug 13, 2010 Accepting new patients
MRG Health Texas PLLC Past Accepting new patients
North Belt East Medical Clinic PA PastSince Feb 29, 2016 Accepting new patients

Locations

10440 N Central Expy
Ste 1040
Dallas, TX 75231
Phone (832) 225-3345

17070 Red Oak Dr
Ste 209
Houston, TX 77090
Phone (281) 444-1715

4801 Woodway Dr
Ste 306W
Houston, TX 77056
Phone (832) 225-3345

19411 McKay Dr
Ste 200
Humble, TX 77338
Phone (281) 570-4112

9802 FM 1960 Bypass Rd W
Ste 250
Humble, TX 77338
Phone (281) 570-4112

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 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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1083611925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19411 MCKAY DR",
            "address_2": "STE 200",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385722",
            "telephone_number": "281-570-4112",
            "fax_number": "281-570-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19411 MCKAY DR",
            "address_2": "STE 200",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385722",
            "telephone_number": "281-570-4112",
            "fax_number": "281-570-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURZYDLO",
        "first_name": "GRZEGORZ",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L7790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164768701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7946539",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.