Individual provider Active NPI

Senthilnayaki Kasiraja

  • Primary Care Nurse Practitioner
  • Brookshire, TX
National Provider Identifier
1346868536
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1003027 Issued in TX
Practice address
30575 Kingsland Blvd # 150
Brookshire, TX 77423-2844
Phone
(281) 717-4674
Fax
(833) 318-0533
NPI assigned
Jul 14, 2020
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1003027 TX
Primary Care Nurse Practitioner 363LP2300X 1003027 TX Primary
Family Medicine Physician 207Q00000X 1003027 TX

Addresses

Primary practice location

30575 Kingsland Blvd # 150
Brookshire, TX 77423-2844

Mailing address

21319 Wild Jasmine LN
Katy, TX 77450-5452
Phone (407) 403-0967

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
I20211210000377 TX Practitioner - Nurse Practitioner 0941690747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Medical Clinic LLCGroup PAC ID 2163898511, 2 clinicians

Practice addresses (Care Compare)

29911 Jordan Crossing Blvd
Suite 300
Katy, TX 77494-8483
Phone (281) 375-9481

30575 Kingsland Blvd
Suite 150
Brookshire, TX 77423-2844
Phone (346) 477-4686

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1003027TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Testosterone and Weight Loss PLLC CurrentSince Feb 21, 2025 Accepting new patients
Athena Medical Clinic LLC Nurse Practitioner CurrentSince Nov 26, 2022 Accepting new patients

Locations

30575 Kingsland Blvd
Ste 150
Brookshire, TX 77423
Phone (281) 717-4674

29911 Jordan Crossing Blvd
Ste 300
Katy, TX 77494
Phone (281) 375-9481

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBEJCD/Endpoint/BBEJCD

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, 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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1346868536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21319 WILD JASMINE LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774505452",
            "telephone_number": "407-403-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30575 KINGSLAND BLVD # 150",
            "city": "BROOKSHIRE",
            "state": "TX",
            "postal_code": "774232844",
            "telephone_number": "281-717-4674",
            "fax_number": "833-318-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIRAJA",
        "first_name": "SENTHILNAYAKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1003027",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1003027",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1003027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookshire, TX

Sources for this page

Verify at the official NPI Registry.