Individual provider Active NPI

Madhavi Koneru, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
National Provider Identifier
1366642894
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
N8313 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2608
Phone
(832) 824-1000
NPI assigned
Jul 23, 2007
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.089948 OH
Neonatal-Perinatal Medicine Physician 2080N0001X N8313 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2608

Mailing address

2450 Holcombe Blvd Ste 34L
Houston, TX 77021-2041
Phone (832) 828-3660

Other practice location 1

2401, S 31st St
Temple, TX 76502
Phone (254) 724-2311

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
I20110221000333 TX Practitioner - Pediatric MedicinePractitioner - Other (Physician) 5991745002 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.089948OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince May 16, 2018 Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Jan 10, 2011 Accepting new patients
Ut Physicians CurrentSince May 16, 2018 Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Jan 10, 2011 Accepting new patients
Texas Children's Physician Group Pediatrics CurrentSince May 1, 2024 Accepting new patients
Methodist Health Centers Past Accepting new patients
St. Luke's Community Health Services Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: mkoneru310994@direct.houstonmethodist.org
  • Direct secure messaging: mkoneru310994@directhoustonmethodist.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1366642894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 HOLCOMBE BLVD STE 34L",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212041",
            "telephone_number": "832-828-3660",
            "fax_number": "254-724-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401, S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "76502",
            "country_code": "US",
            "telephone_number": "254-724-2311",
            "fax_number": "254-724-9402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONERU",
        "first_name": "MADHAVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.089948",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "N8313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.