Individual provider Active NPI

Ewa Elenberg, MD

  • Pediatric Nephrology Physician
  • Houston, TX
National Provider Identifier
1255411591
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
K2455 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2316
Phone
(832) 824-3800
Fax
(832) 825-3889
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X K2455 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2316

Mailing address

6701 Fannin St
Houston, TX 77030-2316
Phone (832) 824-3800

Other identifiers 1

IdentifierTypeStateIssuer
119035704MedicaidTX

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
I20080826000452 TX Practitioner - Pediatric MedicinePractitioner - Nephrology 7911072954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Nephrology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

Hospital & facility affiliations

  • Texas Childrens Hospital Hospital, Houston, TX, CCN 453304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K2455TXMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Jul 1, 2008 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6701 Fannin St
Fl 11
Houston, TX 77030
Phone (832) 822-3540

2 Greenway Plz
Ste 300
Houston, TX 77046
Phone (832) 828-3603

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

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

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Houston, TX 77046
Phone (713) 798-1700

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

Interoperability endpoints

  • Direct secure messaging: eelenberg5799@prddirect.texaschildrens.org

Organizations & group practices 6

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 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1255411591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302316",
            "telephone_number": "832-824-3800",
            "fax_number": "832-825-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302316",
            "telephone_number": "832-824-3800",
            "fax_number": "832-825-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELENBERG",
        "first_name": "EWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "K2455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119035704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.