Individual provider Active NPI

Roham Darvishi, M.D.

  • Internal Medicine Physician
  • Conroe, TX
National Provider Identifier
1346261591
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M1067 Issued in TX
Practice address
3115 College Park Dr Ste 108
Conroe, TX 77384-4171
Phone
(832) 860-7450
NPI assigned
Jul 22, 2006
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M1067 TX Primary
Internal Medicine Physician 207R00000X 229117 NY

Addresses

Primary practice location

3115 College Park Dr Ste 108
Conroe, TX 77384-4171

Mailing address

15 Summer PRT
Spring, TX 77381-4269
Phone (832) 860-7450

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
I20080402000405 TX Practitioner - Internal Medicine 8729165600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Houston Cancer Clinics PAGroup PAC ID 7517097124, 2 clinicians

Practice addresses (Care Compare)

3115 College Park Dr
Suite 108
The Woodlands, TX 77384-4171
Phone (936) 439-5213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229117NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Houston Cancer Clinics PA CurrentSince Oct 23, 2013 Accepting new patients
North Houston Cancer Clinics PA CurrentSince Oct 23, 2013 Accepting new patients
North Houston Hospitalists PA Internal Medicine Past Accepting new patients

Locations

3233 Woodward Dr
Huntsville, TX 77340
Phone (832) 798-7875

3115 College Park Dr
Ste 108
The Woodlands, TX 77384
Phone (936) 439-5213

Organizations & group practices 3

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 2

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1346261591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SUMMER PRT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773814269",
            "telephone_number": "832-860-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 COLLEGE PARK DR STE 108",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844171",
            "telephone_number": "832-860-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARVISHI",
        "first_name": "ROHAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1067",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "229117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.