Individual provider Active NPI

Kamran Kheder, MD

  • Family Medicine Physician
  • Katy, TX
National Provider Identifier
1346829173
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.148228 Issued in OH
Practice address
3919 Fry Rd
Katy, TX 77449-6731
Phone
(281) 646-2273
Fax
(281) 646-9511
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.148228 OH Primary
Family Medicine Physician 207Q00000X U7702 TX

Addresses

Primary practice location

3919 Fry Rd
Katy, TX 77449-6731

Mailing address

3919 Fry Rd
Katy, TX 77449-6731
Phone (281) 646-2273

Other practice location 1

297 N Main St Ste 7
Munroe Falls, OH 44262-1077
Phone (713) 972-0092

Other names 1

  • Kamran Khederzadeh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240524001124 TX Practitioner - Family Practice 7416359906 Reassigns benefits to 1 organization
I20241004000688 OH Practitioner - Family Practice 7416359906 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Plus Clinic, PA Family Medicine CurrentSince May 4, 2024 Accepting new patients
Family Care Plus Clinic LLC Family Medicine CurrentSince Jul 6, 2024 Accepting new patients

Locations

297 N Main St
Ste 7
Munroe Falls, OH 44262
Phone (330) 765-4141

3919 Fry Rd
Katy, TX 77449
Phone (281) 646-2273

Interoperability endpoints

  • Direct secure messaging: kamran.kheder.2@17800.direct.athenahealth.com

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1346829173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 FRY RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496731",
            "telephone_number": "281-646-2273",
            "fax_number": "281-646-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 FRY RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496731",
            "telephone_number": "281-646-2273",
            "fax_number": "281-646-9511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "297 N Main St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Munroe Falls",
            "state": "OH",
            "postal_code": "442621077",
            "country_code": "US",
            "telephone_number": "713-972-0092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEDER",
        "first_name": "KAMRAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.148228",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U7702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMRAN",
            "last_name": "KHEDERZADEH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.