Individual provider Active NPI

Caleb Shea Deike, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Humble, TX
National Provider Identifier
1457993065
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP143502 Issued in TX
Practice address
17903 W Lake Houston Pkwy Ste 201
Humble, TX 77346-3954
Phone
(281) 446-7173
Fax
(281) 446-3841
NPI assigned
Oct 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 AP143502 TX Primary

Addresses

Primary practice location

17903 W Lake Houston Pkwy Ste 201
Humble, TX 77346-3954

Mailing address

17903 W Lake Houston Pkwy Ste 201
Humble, TX 77346-3954
Phone (281) 446-7173

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
I20200109000287 TX Practitioner - Nurse Practitioner 0547695199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.57 of 100Reported as group
Quality
82.69
Improvement activities
40
Cost
81.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mehta Medical Group PLLC CurrentSince Sep 1, 2024 Accepting new patients
Woodrome Medical PA CurrentSince Dec 18, 2019 Accepting new patients

Locations

1702 FM 1960 Bypass Rd E
Humble, TX 77338
Phone (281) 446-7371

17903 W Lake Houston Pkwy
Ste 201
Humble, TX 77346
Phone (281) 446-7371

Interoperability endpoints

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

Organizations & group practices 2

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1457993065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17903 W LAKE HOUSTON PKWY STE 201",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463954",
            "telephone_number": "281-446-7173",
            "fax_number": "281-446-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17903 W LAKE HOUSTON PKWY STE 201",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773463954",
            "telephone_number": "281-446-7173",
            "fax_number": "281-446-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIKE",
        "first_name": "CALEB",
        "middle_name": "SHEA",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.