Individual provider Active NPI

Nicholas Patrick Stetkevich, D.O.

  • Pediatric Sports Medicine Physician
  • Sugar Land, TX
National Provider Identifier
1164803375
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
S6061 Issued in TX
Practice address
15400 Southwest Fwy Ste 100
Sugar Land, TX 77478-3876
Phone
(281) 494-7010
Fax
(832) 825-3689
NPI assigned
Jun 12, 2015
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 007585 AZ
Pediatrics Physician 208000000X S6061 TX
Pediatric Sports Medicine Physician 2080S0010X S6061 TX Primary

Addresses

Primary practice location

15400 Southwest Fwy Ste 100
Sugar Land, TX 77478-3876

Mailing address

2212 W Holcombe Blvd
Houston, TX 77030-2088
Phone (408) 355-0924

Other practice location 1

6330 West Loop S Ste 300
Bellaire, TX 77401-2936
Phone (713) 839-0164

Other practice location 2

6621 Fannin St Ste Ab2240
Houston, TX 77030-2358
Phone (832) 824-2000

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
I20240313004131 TX Practitioner - Pediatric Medicine 2860705191 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007585AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Pediatrics CurrentSince Mar 1, 2024 Accepting new patients
Texas Children's Hospital Past Accepting new patients
Texas Children's Urgent Care Pediatrics PastSince May 1, 2021 Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

6330 West Loop S
Ste 300
Bellaire, TX 77401
Phone (713) 839-0164

6621 Fannin St
Ste AB2240
Houston, TX 77030
Phone (832) 824-2000

6651 Main St
Ste F320
Houston, TX 77030
Phone (512) 828-3660

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

15400 Southwest Fwy
Ste 100
Sugar Land, TX 77478
Phone (281) 494-7010

Interoperability endpoints

  • Direct secure messaging: nstetkevich307161@prddirect.texaschildrens.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1164803375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 W HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302088",
            "telephone_number": "408-355-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 SOUTHWEST FWY STE 100",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783876",
            "telephone_number": "281-494-7010",
            "fax_number": "832-825-3689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 West Loop S Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012936",
            "country_code": "US",
            "telephone_number": "713-839-0164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6621 Fannin St Ste Ab2240",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302358",
            "country_code": "US",
            "telephone_number": "832-824-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STETKEVICH",
        "first_name": "NICHOLAS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "007585",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S6061",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "TX",
            "license": "S6061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.