Individual provider Active NPI

Chaitanya Alli, M.D

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1134329782
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N0604 Issued in TX
Practice address
2060 Space Park Dr Ste 302
Houston, TX 77058
Phone
(281) 333-9747
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116017080 VA
Family Medicine Physician 207Q00000X N0604 TX Primary

Addresses

Primary practice location

2060 Space Park Dr Ste 302
Houston, TX 77058

Mailing address

2060 Space Park Dr Ste 302
Houston, TX 77058-3675
Phone (281) 333-9747

Other practice location 1

302 Highway 3 S
League City, TX 77573-3755
Phone (281) 332-6573

Other practice location 2

302 Highway 3 S
League City, TX 77573-3755
Phone (281) 332-6573

Other identifiers 2

IdentifierTypeStateIssuer
200874002MedicaidTX
1134329782OtherTXNPI

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
I20090305000560 TX Practitioner - Family Practice 4789740358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians

Practice addresses (Care Compare)

2060 Space Park Dr
Suite 302
Houston, TX 77058-3675
Phone (281) 648-4800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N0604TXMDFamily Medicine Physician
0116017080VAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: calli219576@directhoustonmethodist.org

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 3

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1134329782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 SPACE PARK DR STE 302",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583675",
            "telephone_number": "281-333-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 SPACE PARK DR STE 302",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77058",
            "telephone_number": "281-333-9747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Highway 3 S",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775733755",
            "country_code": "US",
            "telephone_number": "281-332-6573",
            "fax_number": "281-332-7409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Highway 3 S",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775733755",
            "country_code": "US",
            "telephone_number": "281-332-6573",
            "fax_number": "281-332-7409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLI",
        "first_name": "CHAITANYA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116017080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200874002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1134329782",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.