Individual provider Active NPI

Tristan Grimaldo, FNP-C

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1447626015
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128681 Issued in TX
Practice address
9190 Katy Fwy Ste 101
Houston, TX 77055-7440
Phone
(832) 358-8600
Fax
(832) 358-0376
NPI assigned
Aug 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128681 TX Primary

Addresses

Primary practice location

9190 Katy Fwy Ste 101
Houston, TX 77055-7440

Mailing address

9190 Katy Fwy Ste 101
Houston, TX 77055-7440
Phone (832) 358-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128681TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kai Health Solutions PLLC PastSince Apr 9, 2024 Accepting new patients
Reproductive Urology, LLC Past Accepting new patients
Male Reproductive Clinic Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGGDDD/Endpoint/IGGDDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1447626015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9190 KATY FWY STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770557440",
            "telephone_number": "832-358-8600",
            "fax_number": "832-358-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9190 KATY FWY STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770557440",
            "telephone_number": "832-358-8600",
            "fax_number": "832-358-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDO",
        "first_name": "TRISTAN",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.