Individual provider Active NPI

John W Cassidy, M.D.

  • Brain Injury Medicine (Psychiatry & Neurology) Physician
  • Houston, TX
National Provider Identifier
1114097748
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Brain Injury Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P0301X
License
H3450 Issued in TX
Practice address
1 Riverway
Suite 600
Houston, TX 77056-1920
Phone
(713) 355-6111
Fax
(713) 355-6822
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X H3450 TX
Neurology Physician 2084N0400X H3450 TX
Neurodevelopmental Disabilities Physician 2084P0005X H3450 TX
Psychiatry Physician 2084P0800X H3450 TX
Brain Injury Medicine (Psychiatry & Neurology) Physician 2084P0301X H3450 TX Primary

Addresses

Primary practice location

1 Riverway
Suite 600
Houston, TX 77056-1920

Mailing address

1 Riverway Ste 700
Houston, TX 77056-1988
Phone (713) 355-6111

Other names 1

  • Dr. John Wayne Cassidy, PA Professional name

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
I20120307000150 TX Practitioner - PsychiatryPractitioner - Internal Medicine 9931017019 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nexus Physicians Services PLLC CurrentSince Jul 1, 2011 Accepting new patients
Cubellis Enterprises, LLC Current Accepting new patients
VSC Hbo, LLC PastSince Mar 4, 2003 Accepting new patients

Locations

1 Riverway
Ste 700
Houston, TX 77056
Phone (713) 355-6111

2929 Woodland Park Dr
Houston, TX 77082
Phone (281) 293-7774

1 Riverway
Ste 600
Houston, TX 77056
Phone (713) 355-6111

123 Vision Park Blvd
Shenandoah, TX 77384
Phone (281) 364-0317

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthbridge Children'S Hospital - Houston, LTD.Houston, TX, CCN 453309 Hospital Corporate Director Mar 5, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1114097748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERWAY STE 700",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770561988",
            "telephone_number": "713-355-6111",
            "fax_number": "713-355-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERWAY",
            "address_2": "SUITE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770561920",
            "telephone_number": "713-355-6111",
            "fax_number": "713-355-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "TX",
            "license": "H3450",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "H3450",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "TX",
            "license": "H3450",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H3450",
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": "TX",
            "license": "H3450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "CASSIDY, PA",
            "middle_name": "WAYNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.