Organization Active NPI

Ipseity Diagnostics LLC

  • Clinical Medical Laboratory
  • Houston, TX
National Provider Identifier
1346819992
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
IPSEITY DIAGNOSTICS LLC
Practice address
2323 S Voss Rd Ste 240
Houston, TX 77057-3814
Phone
(848) 219-6074
NPI assigned
Jun 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Mr. Mahesh Kankanala
Title
Managing Member
Phone
(848) 219-6074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2323 S Voss Rd Ste 240
Houston, TX 77057-3814

Mailing address

2323 S Voss Rd Ste 240
Houston, TX 77057-3814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210915001969 TX Part B Supplier - Independent Clinical Laboratory 5991101065 Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

2323 S Voss Rd
Ste 240
Houston, TX 77057
Phone (848) 219-6074

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1346819992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S VOSS RD STE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S VOSS RD STE 240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770573814",
            "telephone_number": "848-219-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPSEITY DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "KANKANALA",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "848-219-6074",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "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 Jun 18, 2021; 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.