Organization Active NPI

Memorial Pulmonology PA

  • Pulmonary Disease Physician
  • Houston, TX
National Provider Identifier
1093993909
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
L7782 Issued in TX
Legal business name
MEMORIAL PULMONOLOGY PA
Practice address
10837 Katy Fwy
Suite 100
Houston, TX 77079-2207
Phone
(832) 325-1200
Fax
(713) 984-8260
NPI assigned
Feb 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Anatoli N Krasko, MDNPI 1215962733
Title
Director
Phone
(832) 325-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X L7782 TX
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X L7782 TX
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X L7782 TX Primary

Addresses

Primary practice location

10837 Katy Fwy
Suite 100
Houston, TX 77079-2207

Mailing address

10837 Katy Fwy
Suite 100
Houston, TX 77079-2207
Phone (832) 325-1200

Other identifiers 1

IdentifierTypeStateIssuer
178025601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000913 TX Part B Supplier - Clinic/Group Practice 2860410248 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

10837 Katy Fwy
Ste 100
Houston, TX 77079
Phone (832) 325-1200

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1093993909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10837 KATY FWY",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792207",
            "telephone_number": "832-325-1200",
            "fax_number": "713-984-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10837 KATY FWY",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770792207",
            "telephone_number": "832-325-1200",
            "fax_number": "713-984-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PULMONOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "KRASKO",
        "authorized_official_first_name": "ANATOLI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "832-325-1200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L7782",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "L7782",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "L7782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178025601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.