Individual provider Active NPI

Richard J Kondejewski, M.D.

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1174546204
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
F0548 Issued in TX
Practice address
16000 Park Ten PL Ste 802
Houston, TX 77084
Phone
(281) 519-7826
Fax
(281) 944-9359
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X F0548 TX Primary

Addresses

Primary practice location

16000 Park Ten PL Ste 802
Houston, TX 77084

Mailing address

PO Box 1608
League City, TX 77574-1608
Phone (713) 776-0091

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dynacare Medical & Chiropractic Past Accepting new patients
Healthcare & Wellness Past Accepting new patients
Munzoor Ahmad Rana Texas Medical and Chiropractic Centers Past Accepting new patients
Adom Rehab and Physical Medicine Past Accepting new patients

Organizations & group practices 4

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1174546204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1608",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775741608",
            "telephone_number": "713-776-0091",
            "fax_number": "713-776-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 PARK TEN PL STE 802",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77084",
            "telephone_number": "281-519-7826",
            "fax_number": "281-944-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDEJEWSKI",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "F0548",
            "primary": true
        }
    ],
    "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 Jun 15, 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.