Individual provider Active NPI

Neeraja Krishnasamudram

  • Hospitalist Physician
  • Shenandoah, TX
National Provider Identifier
1174082978
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
T4780 Issued in TX
Practice address
9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone
(713) 897-2307
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T4780 TX
Hospitalist Physician 208M00000X T4780 TX Primary

Addresses

Primary practice location

9250 Pinecroft Dr
Shenandoah, TX 77380-3218

Mailing address

9250 Pinecroft Dr
Shenandoah, TX 77380-3218

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
I20220926003377 TX Practitioner - HospitalistPractitioner - Internal Medicine 8921484189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

1801 N Loop W
Suite 30
Houston, TX 77008-1445
Phone (713) 802-9781

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone (713) 897-2307

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group Internal Medicine CurrentSince Sep 11, 2022 Accepting new patients
Hni Medical Services Internal Medicine Past Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

23900 Katy Fwy
Ste W2100
Katy, TX 77494
Phone (281) 644-7000

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1174082978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 PINECROFT DR",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 PINECROFT DR",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803218",
            "telephone_number": "713-897-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNASAMUDRAM",
        "first_name": "NEERAJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-12-01",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4780",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "T4780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.