NPIMap

Organization Active NPI

Medcare Pediatric Rehab Center, LP

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Katy, TX
National Provider Identifier
1114453404
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
MEDCARE PEDIATRIC REHAB CENTER, LP
Practice address
21210 Kingsland Blvd
Katy, TX 77450-5898
Phone
(713) 773-5180
Fax
(281) 994-0188
NPI assigned
May 4, 2017
Last updated
Nov 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDCARE PEDIATRIC GROUP, LPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Authorized official

Name
Paige Kinkade
Title
Ceo
Phone
(713) 995-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

21210 Kingsland Blvd
Katy, TX 77450-5898

Mailing address

12371 S Kirkwood Rd
Stafford, TX 77477-2836
Phone (713) 875-7435

Other identifiers 1

IdentifierTypeStateIssuer
1801326-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060330000705 TX Part A Provider - Comprehensive Outpatient Rehabilitation Facility 1759399827 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX; Stafford, TX

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Medcare Pediatric Rehab Center LP11 organizations share this tax ID, including this one
Part of
Medcare Pediatric Group LP

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

21210 Kingsland Blvd
Katy, TX 77450
Phone (713) 759-0932

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1114453404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12371 S KIRKWOOD RD",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772836",
            "telephone_number": "713-875-7435",
            "fax_number": "281-994-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774505898",
            "telephone_number": "713-773-5180",
            "fax_number": "281-994-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCARE PEDIATRIC REHAB CENTER, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDCARE PEDIATRIC GROUP, LP",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "KINKADE",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-995-9292"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801326-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.