Individual provider Active NPI

Ankhi Dutta, M.D., M.P.H.

  • Pediatric Infectious Diseases Physician
  • Conroe, TX
National Provider Identifier
1235378563
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
N1311 Issued in TX
Practice address
17580 Interstate 45 S
Conroe, TX 77384-4972
Phone
(936) 267-5000
NPI assigned
Feb 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N1311 TX
Pediatric Infectious Diseases Physician 2080P0208X N1311 TX Primary

Addresses

Primary practice location

17580 Interstate 45 S
Conroe, TX 77384-4972

Mailing address

17580 Interstate 45 S Ste Wa360
Conroe, TX 77384-4972
Phone (936) 267-5000

Other identifiers 1

IdentifierTypeStateIssuer
187842301MedicaidTX

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
I20180619000330 TX Practitioner - Pediatric Medicine 1850532730 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Pediatrics CurrentSince Apr 2, 2018 Accepting new patients
Texas Children'S Hospital Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

17580 Interstate 45 S
#360
Conroe, TX 77384

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

17580 Interstate 45 S
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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1235378563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17580 INTERSTATE 45 S STE WA360",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844972",
            "telephone_number": "936-267-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17580 INTERSTATE 45 S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844972",
            "telephone_number": "936-267-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTA",
        "first_name": "ANKHI",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N1311",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TX",
            "license": "N1311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.