Individual provider Active NPI

Michael Ferdkoff, RSA

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1144496290
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
238.000059 Issued in IL
Practice address
7324 Southwest Freeway Suite 1550
Houston, TX 77074-2053
Phone
(713) 779-9800
Fax
(713) 779-9813
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X 238.000059 IL
Surgical Physician Assistant 363AS0400X 238.000059 IL Primary
Surgical Assistant 246ZC0007X 238000059 IL

Addresses

Primary practice location

7324 Southwest Freeway Suite 1550
Houston, TX 77074-2053

Mailing address

7324 Southwest Freeway Suite 1550
Houston, TX 77074-2053
Phone (713) 779-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
238000059ILMDSurgical Assistant
238.000059ILMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1144496290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7324 SOUTHWEST FREEWAY SUITE 1550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742053",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7324 SOUTHWEST FREEWAY SUITE 1550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742053",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERDKOFF",
        "first_name": "MICHAEL",
        "credential": "RSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "238.000059",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238.000059",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238000059",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.