Individual provider Active NPI

John Paek, D.O.

  • Surgery Physician
  • Kingwood, TX
National Provider Identifier
1225452907
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
S1478 Issued in TX
Practice address
22999 Highway 59 N Ste B220
West Tower
Kingwood, TX 77339-4460
Phone
(682) 224-3748
Fax
(682) 841-0039
NPI assigned
Feb 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X S1478 TX Primary

Addresses

Primary practice location

22999 Highway 59 N Ste B220
West Tower
Kingwood, TX 77339-4460

Mailing address

800 8TH Ave Ste 306
Fort Worth, TX 76104-2602
Phone (682) 224-3748

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
I20190731003368 TX Practitioner - General SurgeryPractitioner - General Practice 4688900442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Surgical Specialists PLLCGroup PAC ID 8921364100, 32 clinicians

Practice addresses (Care Compare)

22999 Hwy 59 N
Suite B220
Kingswood, TX 77339-4460
Phone (281) 516-8184

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1478TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Aug 5, 2019 Accepting new patients
Little Lantern Clinic LLC Surgery CurrentSince Jul 15, 2020 Accepting new patients
TMH Physician Associates PLLC CurrentSince Aug 5, 2019 Accepting new patients

Locations

4541 N Josey Ln
Ste 110
Carrollton, TX 75010
Phone (469) 775-9555

9 Medical Pkwy
Ste 210
Farmers Branch, TX 75234
Phone (214) 449-6511

6550 Fannin St
Ste 1501
Houston, TX 77030
Phone (713) 441-5141

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

Interoperability endpoints

  • Direct secure messaging: jpaek235613@directhoustonmethodist.org
  • Direct secure messaging: jpaek223204@direct.hfhs.org
  • Direct secure messaging: john.paek@ntss.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

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": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1225452907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 306",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042602",
            "telephone_number": "682-224-3748",
            "fax_number": "682-841-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22999 HIGHWAY 59 N STE B220",
            "address_2": "WEST TOWER",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394460",
            "telephone_number": "682-224-3748",
            "fax_number": "682-841-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAEK",
        "first_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-14",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "S1478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.