Individual provider Active NPI

Kathleen Zavalla

  • Adult Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1114308673
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP128153 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030
Phone
(713) 792-6238
NPI assigned
Jun 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP128153 TX
Adult Health Nurse Practitioner 363LA2200X AP128153 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030

Mailing address

6620 Main St Ste 1325
Houston, TX 77030-2332
Phone (713) 798-6376

Other practice location 1

1814 Matthew Glen Ln
Richmond, TX 77469-1689
Phone (713) 824-6578

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krveloso@mdanderson.org Direct

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
I20160311000179 TX Practitioner - Nurse Practitioner 8426354846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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
AP128153TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 5, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Jan 5, 2016 Accepting new patients
Physicians Referral Service CurrentSince Aug 6, 2019 Accepting new patients

Locations

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

6620 Main St
Ste 1325
Houston, TX 77030
Phone (713) 798-4001

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

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

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

Interoperability endpoints

  • Direct secure messaging: kzavalla16260@utmdandersoncc.direct-ci.com

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.

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": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1114308673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 MAIN ST STE 1325",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302332",
            "telephone_number": "713-798-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-792-6238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1814 Matthew Glen Ln",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774691689",
            "country_code": "US",
            "telephone_number": "713-824-6578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVALLA",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP128153",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP128153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krveloso@mdanderson.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1515 Holcombe Blvd",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.