Individual provider Active NPI

Supriya Nair, MD

  • Pediatric Gastroenterology Physician
  • Houston, TX
National Provider Identifier
1417223769
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
R0460 Issued in TX
Practice address
6431 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-7708
NPI assigned
Mar 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 R0460 TX
Pediatric Gastroenterology Physician 2080P0206X R0460 TX Primary

Addresses

Primary practice location

6431 Fannin St
Houston, TX 77030-1501

Mailing address

6401 Fannin St
Houston, TX 77030

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
I20181108001673 TX Practitioner - Pediatric Medicine 6103170246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

2620 E Crosstimbers St
Suite 100
Houston, TX 77093-8639
Phone (713) 486-8550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0460TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Oct 9, 2018 Accepting new patients
Physicians Referral Service CurrentSince May 31, 2019 Accepting new patients
Ut Physicians Pediatrics CurrentSince Oct 9, 2018 Accepting new patients

Locations

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

6431 Fannin St
Houston, TX 77030
Phone (713) 500-5800

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

6410 Fannin St
Ste LL135
Houston, TX 77030
Phone (832) 325-6543

2620 E Crosstimbers St
Ste 100
Houston, TX 77093
Phone (713) 486-8550

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

8810 Highway 6
Ste 100
Sienna Plantation, TX 77459
Phone (713) 486-1200

Interoperability endpoints

  • Direct secure messaging: snair14525@direct.uth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1417223769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "SUPRIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R0460",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "R0460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.