Individual provider Active NPI

Malini Randeep, PA

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1336388537
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05256 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 704-4000
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05256 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

PO Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 2

IdentifierTypeStateIssuer
200987001MedicaidTX
8Y9514OtherTXBLUE CROSS BLUE SHIELD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000475 TX Practitioner - Physician Assistant 0446317804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05256TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 2, 2022 Accepting new patients
Ut Physicians Physician Assistant CurrentSince Aug 2, 2022 Accepting new patients

Locations

6431 Fannin St
#450
Houston, TX 77030
Phone (713) 500-7885

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1336388537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-704-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDEEP",
        "first_name": "MALINI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200987001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y9514",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.