Individual provider Active NPI

Rachel Koller, DNP, NP

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1093552655
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1167693 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone
(713) 792-6161
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1167693 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917000253 TX Practitioner - Nurse Practitioner 9436690526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-2121

Hospital & facility affiliations

  • University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1167693TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Aug 19, 2024 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

Organizations & group practices 1

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": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1093552655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "RACHEL",
        "credential": "DNP, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1167693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.