Active NPI
Amanda A Gujral, AGPCNP-BC
- Nurse Practitioner
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1008679
- Practice address
- 15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487 - Phone
- (713) 442-1700
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 841553 | TX | |
| Nurse Practitioner | 363L00000X | 1008679 | TX | Primary |
Addresses
Primary practice location
15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487
Mailing address
11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 418496201 | Medicaid | TX |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | agujral23663@direct.kelsey-seybold.com | Direct | |
| Other URL | amanda.a.gujral@uth.tmc.edu | ||
| FHIR URL | https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 841553 | TX | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Practice House Calls LLC | Nurse Practitioner | Current | Accepting new patients |
| Kelsey-Seybold Medical Group, PLLC | Current | Accepting new patients | |
| Advance Pharmacy LLC | Past | Accepting new patients |
Locations
2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412
2646 S Loop W
Ste 330
Houston, TX 77054
Phone (281) 888-4407
15655 Cypress Wood Medical Dr
Ste 100
Houston, TX 77014
Phone (713) 442-1700
11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997
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.
-
- Nurse Practitioner
- Houston, TX
- NPI 1841830445
-
- Multi-Specialty Clinic/Center
- Houston, TX
- NPI 1013915255
-
- Community/Retail Pharmacy
- Houston, TX
- NPI 1962771733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1194376624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11511 SHADOW CREEK PKWY",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775847298",
"telephone_number": "713-442-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15655 CYPRESS WOOD MEDICAL DR STE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770141487",
"telephone_number": "713-442-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUJRAL",
"first_name": "AMANDA",
"middle_name": "A",
"credential": "AGPCNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "841553",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1008679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "418496201",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "agujral23663@direct.kelsey-seybold.com",
"affiliation": "N",
"endpointDescription": "digital contact information",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "15655 Cypress Wood Medical Dr Ste 100",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770141487",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "amanda.a.gujral@uth.tmc.edu",
"affiliation": "N",
"address_1": "1822 Brun St",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770195713",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR endpoint URL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "15655 Cypress Wood Medical Dr Ste 100",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770141487",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.