Individual provider Active NPI

Joseph Cyriac, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1174215552
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17339 Issued in TX
Practice address
5656 Kelley St # 1Ec1347
Houston, TX 77026-1975
Phone
(713) 566-5100
NPI assigned
May 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6085 CT
Physician Assistant 363A00000X PA17339 TX Primary

Addresses

Primary practice location

5656 Kelley St # 1Ec1347
Houston, TX 77026-1975

Mailing address

6431 Fannin St Ste JJL 270
Houston, TX 77030-1501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230814000960 CT Practitioner - Physician Assistant 1951763606 Reassigns benefits to 2 organizations
I20240930000729 TX Practitioner - Physician Assistant 1951763606 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 25, 2023 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Sep 23, 2024 Accepting new patients
Ut Physicians CurrentSince Sep 23, 2024 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

20171 Chasewood Park Dr
Houston, TX 77070
Phone (713) 355-1000

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

6431 Fannin St
Ste Jjl
Houston, TX 77030
Phone (713) 500-7878

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

5656 Kelley St
#1
Houston, TX 77026
Phone (713) 500-7885

1705 Jackson St
Richmond, TX 77469
Phone (281) 341-3000

1317 Lake Pointe Pkwy
Sugar Land, TX 77478
Phone (281) 277-1101

17400 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-4055

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

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.

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1174215552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE JJL 270",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 KELLEY ST # 1EC1347",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770261975",
            "telephone_number": "713-566-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6085",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.