Individual provider Active NPI

Varughese Max Baby, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1417107293
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
781646 Issued in TX
Practice address
4314 Yoakum Blvd
Houston, TX 77006-5818
Phone
(713) 850-0049
Fax
(713) 850-0036
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 525591 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 781646 TX Primary

Addresses

Primary practice location

4314 Yoakum Blvd
Houston, TX 77006-5818

Mailing address

3430 Hidden Creek Dr
Sugar Land, TX 77479-1651
Phone (516) 749-3845

Other identifiers 10

IdentifierTypeStateIssuer
215863603MedicaidTX
215863602MedicaidTX
215863605MedicaidTX
P00967678OtherTXRAIL ROAD MCR DALLAS
859N32OtherTXBCBS TX
215863604MedicaidTX
P00889009OtherTXRAIL ROAD MEDICARE
834N18OtherTXBCBS TX
215863601MedicaidTX
847N28OtherTXBCBS TX

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
I20101029000899 TX Practitioner - Nurse Practitioner 2769676170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Televero Health PAGroup PAC ID 7911318241, 37 clinicians

Practice addresses (Care Compare)

6101 W Courtyard Dr
Suite 2 225
Austin, TX 78730-5044
Phone (512) 956-5003

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
67.33

Merit-based Incentive Payment System (MIPS)

Final score
79.54 of 100Reported as group
Quality
72.94
Improvement activities
40
Cost
48.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
781646TXMDPsychiatric/Mental Health Nurse Practitioner
525591NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Med Management Indiana PC CurrentSince Jun 1, 2021 Accepting new patients
Med Management Associates CurrentSince May 1, 2016 Accepting new patients
US Televero Health PA Psychiatric/Mental Health CurrentSince Jul 11, 2024 Accepting new patients
Aslam Loya, M.D. P.a Past Accepting new patients

Locations

14688 Illinois Highway 82
Geneseo, IL 61254
Phone (309) 944-2147

3830 Mustang Rd
Alvin, TX 77511
Phone (281) 585-8484

6101 W Courtyard Dr
Ste 2-225
Austin, TX 78730
Phone (877) 474-0155

4006 Vista Rd
Pasadena, TX 77504
Phone (713) 943-1592

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 4

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1417107293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 HIDDEN CREEK DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791651",
            "telephone_number": "516-749-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 YOAKUM BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065818",
            "telephone_number": "713-850-0049",
            "fax_number": "713-850-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABY",
        "first_name": "VARUGHESE",
        "middle_name": "MAX",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "525591",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "781646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215863603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215863602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215863605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MCR DALLAS",
            "identifier": "P00967678",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "859N32",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215863604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00889009",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "834N18",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215863601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "847N28",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.