NPIMap

Individual provider Active NPI

Judith Tombobi Peyechu, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Humble, TX
National Provider Identifier
1275720427
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
P9935 Issued in TX
Practice address
107 Granberry St
Humble, TX 77338-4547
Phone
(832) 644-6496
Fax
(832) 644-6499
NPI assigned
Oct 2, 2007
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P9935 TX
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X P9935 TX Primary

Addresses

Primary practice location

107 Granberry St
Humble, TX 77338-4547

Mailing address

8340 Greenleaf Ridge Way
Apt C2
Conroe, TX 77385-1119
Phone (240) 463-0848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929001917 TX Practitioner - Hospice/Palliative CarePractitioner - Family Practice 5294982336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8340 Greenleaf Ridge Way
Conroe, TX 77385-1119
Phone (936) 213-0544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P9935TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Healthstar Clinical Associates PLLC Hospice and Palliative Medicine CurrentSince Sep 1, 2022 Accepting new patients

Locations

9803 Highway 242
Ste 200265
Conroe, TX 77385

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1275720427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 GREENLEAF RIDGE WAY",
            "address_2": "APT C2",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773851119",
            "telephone_number": "240-463-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 GRANBERRY ST",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384547",
            "telephone_number": "832-644-6496",
            "fax_number": "832-644-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYECHU",
        "first_name": "JUDITH",
        "middle_name": "TOMBOBI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P9935",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "P9935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.