Individual provider Active NPI

Andrea Nicole Marcogliese, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Houston, TX
National Provider Identifier
1205910486
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L7884 Issued in TX
Practice address
6621 Fannin Street
Houston, TX 77030-2399
Phone
(832) 824-1866
Fax
(832) 825-1032
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L7884 TX Primary
Hematology (Pathology) Physician 207ZH0000X L7884 TX

Addresses

Primary practice location

6621 Fannin Street
Houston, TX 77030-2399

Mailing address

PO Box 741169
Houston, TX 77274-1169
Phone (832) 824-1866

Other identifiers 2

IdentifierTypeStateIssuer
186366403MedicaidTX
186366402MedicaidTX

Other names 1

  • Andrea Marcogliese Sheehan Former name

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
I20070426000266 TX Practitioner - PathologyPractitioner - Hematology 5395841035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens HospitalGroup PAC ID 0244298446, 23 clinicians

Practice addresses (Care Compare)

9835 N Lake Creek Pkwy
Austin, TX 78717-6210
Phone (737) 229-2203

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Childrens Hospital Hematology Current Accepting new patients
Texas Childrens Hospital Anatomic Pathology & Clinical Pathology CurrentSince Aug 14, 2006 Accepting new patients

Locations

18200 Katy Fwy
Houston, TX 77094
Phone (832) 227-1000

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
Ste WB1100
Houston, TX 77030
Phone (832) 824-6422

17600 Interstate 45 S
Ste WL270
The Woodlands, TX 77384
Phone (936) 267-5000

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1205910486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741169",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772741169",
            "telephone_number": "832-824-1866",
            "fax_number": "832-825-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-824-1866",
            "fax_number": "832-825-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOGLIESE",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L7884",
            "primary": true
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "TX",
            "license": "L7884",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186366403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186366402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SHEEHAN",
            "middle_name": "MARCOGLIESE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.