NPIMap

Individual provider Active NPI

Susan E Pelini, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1154370914
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N1831 Issued in TX
Practice address
6410 Fannin St
600
Houston, TX 77030-3000
Phone
(832) 325-7100
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35049052 OH
Internal Medicine Physician 207R00000X N1831 TX Primary

Addresses

Primary practice location

6410 Fannin St
600
Houston, TX 77030-3000

Mailing address

1133 John Freeman Blvd
Jjls80
Houston, TX 77030-1088
Phone (713) 500-6700

Other identifiers 3

IdentifierTypeStateIssuer
8BZ715OtherTXBCBSTX
0628315MedicaidOH
201723801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090518000248 TX Practitioner - Internal Medicine 9436146271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Physicians Specialty ServicesGroup PAC ID 2567544570, 83 clinicians

Practice addresses (Care Compare)

1333 Moursund St
Houston, TX 77030-3405
Phone (713) 799-5000

6410 Fannin St
Houston, TX 77030-3000

6410 Fannin St
Suite 510
Houston, TX 77030-3005
Phone (713) 500-5736

Hospital & facility affiliations

  • Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Tirr Memorial Hermann Inpatient rehabilitation facility, Houston, TX, CCN 453025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35049052OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Specialty Services Internal Medicine CurrentSince Nov 1, 2012 Accepting new patients
West Side Internal Medicine Inc Internal Medicine Past Accepting new patients
Municipality of Skagway Past Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients
Ut Physicians Past Accepting new patients
Ut Physicians Internal Medicine Past Accepting new patients
Fairview Hospital Internal Medicine Past Accepting new patients

Locations

1333 Moursund St
Fl 1
Houston, TX 77030

6410 Fannin St
Ste 600
Houston, TX 77030
Phone (832) 325-7100

6410 Fannin St
Ste 510
Houston, TX 77030
Phone (713) 500-5736

Interoperability endpoints

  • Direct secure messaging: susane.pelini@direct.memorialhermann.org
  • Direct secure messaging: spelini14553@direct.uth.org
  • Direct secure messaging: spelini53107@memorialhermann.direct-ci.com

Organizations & group practices 7

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 9

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1154370914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 JOHN FREEMAN BLVD",
            "address_2": "JJLS80",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301088",
            "telephone_number": "713-500-6700",
            "fax_number": "713-500-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST",
            "address_2": "600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303000",
            "telephone_number": "832-325-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELINI",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35049052",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8BZ715",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0628315",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201723801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.