Individual provider Active NPI

Charles Amoafo Amelemah, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1356788178
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S1971 Issued in TX
Practice address
837 Cypress Creek Pkwy Ste 105
Houston, TX 77090-3422
Phone
(281) 453-7158
Fax
(281) 453-2207
NPI assigned
Jun 3, 2013
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X S1971 TX Primary

Addresses

Primary practice location

837 Cypress Creek Pkwy Ste 105
Houston, TX 77090-3422

Mailing address

837 Cypress Creek Pkwy Ste 105
Houston, TX 77090-3422
Phone (281) 453-7158

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
I20190815002177 TX Practitioner - Internal Medicine 3375831746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unity Hospitalist Group PLLCGroup PAC ID 5698195287, 2 clinicians
Diverse Community Healthcare PLLCGroup PAC ID 7911248646, 2 clinicians

Practice addresses (Care Compare)

1500 Grand Lake Dr
Conroe, TX 77304-2891
Phone (281) 354-2417

18839 McKay Dr
Humble, TX 77338-5721
Phone (281) 354-2417

21693 FM 1314 Rd
Suite 400
Porter, TX 77365-7065
Phone (281) 354-2417

604 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (281) 354-2417

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diverse Community Healthcare PLLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Unity Hospitalist Group PLLC Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Charles a Amelemah Sole MBR Internal Medicine Current Accepting new patients

Locations

1500 Grand Lake Dr
Conroe, TX 77304
Phone (866) 480-0480

1600 Grand Lake Dr
Conroe, TX 77304
Phone (936) 441-8266

196 Camelot St
Conroe, TX 77304
Phone (832) 766-7608

604 S Conroe Medical Dr
Conroe, TX 77304
Phone (505) 980-4582

17506 Red Oak Dr
Houston, TX 77090
Phone (281) 580-1212

837 FM 1960 Rd W
Ste 105
Houston, TX 77090
Phone (281) 453-7158

18839 McKay Dr
Humble, TX 77338
Phone (281) 446-3655

19211 McKay Dr
Humble, TX 77338
Phone (281) 869-5907

21693 FM 1314 Rd
Ste 400
Porter, TX 77365

21898 FM 1314 Rd
#B
Porter, TX 77365
Phone (281) 747-7495

23200 Valley Ranch Pkwy
Porter, TX 77365
Phone (346) 326-5085

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 3

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1356788178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 CYPRESS CREEK PKWY STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903422",
            "telephone_number": "281-453-7158",
            "fax_number": "281-453-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 CYPRESS CREEK PKWY STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903422",
            "telephone_number": "281-453-7158",
            "fax_number": "281-453-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMELEMAH",
        "first_name": "CHARLES",
        "middle_name": "AMOAFO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.