NPIMap

Individual provider Active NPI

Rama Mulukutla, MD

  • Family Medicine Physician
  • Conroe, TX
National Provider Identifier
1407050990
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P8514 Issued in TX
Practice address
605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone
(936) 539-4004
Fax
(936) 539-3635
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P8514 TX Primary

Addresses

Primary practice location

605 S Conroe Medical Dr
Conroe, TX 77304-4722

Mailing address

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828001895 TX Practitioner - Family Practice 8729206040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Vanderbilt University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

17521 St Lukes Way
Suite 190
The Woodlands, TX 77384-8040
Phone (936) 266-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P8514TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Jan 1, 2016 Accepting new patients
Baylor St. Luke's Medical Group Family Medicine CurrentSince Feb 1, 2016 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

20207 Chasewood Park Dr
Ste 300
Houston, TX 77070
Phone (832) 534-7800

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

17350 St Lukes Way
Ste 400
The Woodlands, TX 77384
Phone (832) 249-3721

17198 St Lukes Way
Ste 440
The Woodlands, TX 77384
Phone (936) 266-2500

17521 St Lukes Way
Ste 190
The Woodlands, TX 77384
Phone (936) 266-3400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
  • Direct secure messaging: rmulukutla56921@direct.stlukeshealth.org

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 9

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1407050990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULUKUTLA",
        "first_name": "RAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.