Individual provider Active NPI

Kellen Scott Carril, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1275979122
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R7406 Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 873-2412
NPI assigned
May 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R7406 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X 574206 TX

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

6565 Fannin St # Sm1001
Houston, TX 77030-2703
Phone (713) 441-4431

Other practice location 1

6565 Fannin St # Sm1001
Houston, TX 77030-2703
Phone (713) 441-4431

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
I20200408003141 TX Practitioner - Diagnostic Radiology 6800225111 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians

Practice addresses (Care Compare)

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

17400 St Luke'S Way
CHI St Luke'S Health Lakeside Hospital in T
The Woodlands, TX 77384-8036
Phone (281) 305-4657

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
574206TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 3, 2020 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Baylor College of Medicine CurrentSince Jan 3, 2020 Accepting new patients
Baylor College of Medicine CurrentSince Jan 3, 2020 Accepting new patients
Baylor College of Medicine Diagnostic Radiology CurrentSince Jan 3, 2020 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

2457 S Braeswood Blvd
Houston, TX 77030
Phone (713) 520-8860

1919 Old Spanish Trl
Fl 8
Houston, TX 77054
Phone (713) 798-4321

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

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

6720 Bertner Ave
#270
Houston, TX 77030
Phone (832) 355-4092

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

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

17400 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-4055

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1275979122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST # SM1001",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302703",
            "telephone_number": "713-441-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-873-2412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Fannin St # Sm1001",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "713-441-4431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRIL",
        "first_name": "KELLEN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R7406",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "574206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.