Individual provider Active NPI

Paul Daniel Kanaby, DO

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1275159402
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
U5138 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0354
Phone
(409) 747-0534
Fax
(409) 747-0721
NPI assigned
Jun 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X U5138 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0354

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

15655 Cypress Wood Medical Dr Ste 100
Houston, TX 77014-1487
Phone (713) 442-1700

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
I20230831001119 TX Practitioner - Pediatric Medicine 4981027166 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U5138TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Oct 9, 2023 Accepting new patients
K S Management Services LLC Past Accepting new patients

Locations

15655 Cypress Wood Medical Dr
Ste 100
Houston, TX 77014
Phone (713) 442-1700

15655 Cypress Wood Medical Dr
Houston, TX 77014
Phone (713) 442-1700

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Interoperability endpoints

  • Direct secure messaging: pkanaby67554@direct.kelsey-seybold.com

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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1275159402",
    "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": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550354",
            "telephone_number": "409-747-0534",
            "fax_number": "409-747-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770141487",
            "country_code": "US",
            "telephone_number": "713-442-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANABY",
        "first_name": "PAUL",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U5138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.