Individual provider Active NPI

Jenny H Petkova, MD

  • Hematology (Internal Medicine) Physician
  • Houston, TX
National Provider Identifier
1447202122
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
C10010924 Issued in DE
Practice address
6550 Fannin St Ste 1000
Houston, TX 77030-2717
Phone
(713) 865-1410
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48256 WI
Hematology (Internal Medicine) Physician 207RH0000X C10010924 DE Primary

Addresses

Primary practice location

6550 Fannin St Ste 1000
Houston, TX 77030-2717

Mailing address

6550 Fannin Smith Tower Suite 1001
Houston, TX 77030
Phone (713) 441-1111

Other identifiers 2

IdentifierTypeStateIssuer
34659600MedicaidWI
008806261JOtherHUMANA

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
I20190715000176 TX Practitioner - HematologyPractitioner - Internal Medicine 4486681285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians

Practice addresses (Care Compare)

6445 Main St
Suite 2500
Houston, TX 77030-1502
Phone (713) 441-3150

6550 Fannin St
Suite 1101
Houston, TX 77030-2740
Phone (713) 441-0006

6565 Fannin St
Houston, TX 77030-2703

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10010924DEMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Jul 1, 2019 Accepting new patients
TMH Physician Associates PLLC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

6550 Fannin St
Ste 1101
Houston, TX 77030
Phone (713) 441-0006

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

6550 Fannin St
Ste 1001
Houston, TX 77030
Phone (713) 441-4333

6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633

6550 Fannin St
Ste 1000
Houston, TX 77030
Phone (713) 865-1410

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: jenny.petkova@dclp.ikm.direct-ci.com
  • Direct secure messaging: jpetkova233094@directhoustonmethodist.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.

Hospital & facility affiliations 1

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1447202122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN SMITH TOWER SUITE 1001",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-441-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302717",
            "telephone_number": "713-865-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETKOVA",
        "first_name": "JENNY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "48256",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "DE",
            "license": "C10010924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34659600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "008806261J",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.