Organization Active NPI

Sambasivan, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Houston, TX
National Provider Identifier
1316792831
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
SAMBASIVAN, PLLC
Practice address
810 Waugh Dr Ste 200
Houston, TX 77019-2013
Phone
(713) 522-5111
Fax
(713) 522-6111
NPI assigned
Apr 18, 2024
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Ajai Sambasivan, MDNPI 1992090955
Title
Managing Member
Phone
(512) 913-8242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU Primary

Addresses

Primary practice location

810 Waugh Dr Ste 200
Houston, TX 77019-2013

Mailing address

5213 Laurel St
Bellaire, TX 77401-3926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240923000556 TX Part B Supplier - Clinic/Group Practice 7719428432 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1316792831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 LAUREL ST",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 WAUGH DR STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770192013",
            "telephone_number": "713-522-5111",
            "fax_number": "713-522-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMBASIVAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "SAMBASIVAN",
        "authorized_official_first_name": "AJAI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "512-913-8242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.