Active NPI
Marina Kamyshin, PA-C
- Physician Assistant
- The Woodlands, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA19875
- Practice address
- 8000 Research Forest Dr Ste 360
The Woodlands, TX 77382 - Phone
- (281) 292-1191
- NPI assigned
- Sep 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA13007 | TX | |
| Physician Assistant | 363A00000X | PA19875 | CA | Primary |
Addresses
Primary practice location
8000 Research Forest Dr Ste 360
The Woodlands, TX 77382
Mailing address
8000 Research Forest Dr Ste 360
The Woodlands, TX 77382-1559
Phone (281) 292-1191
Other practice location 1
3441 Marysville Blvd
Sacramento, CA 95838
Phone (916) 563-7234
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17510 W Grand Pkwy S
Sugar Land, TX 77479-2649
7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500
8000 Research Forest Dr
Suite 360
The Woodlands, TX 77382-1559
Phone (281) 292-1192
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA19875 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Gulf Coast, PLLC | Current | Accepting new patients | |
| Privia Medical Group Gulf Coast PLLC | Current | Accepting new patients | |
| River City Medical Group, Inc. | Past | Accepting new patients |
Locations
646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001
7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027
10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500
17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820
8000 Research Forest Dr
Ste 360
The Woodlands, TX 77382
Phone (281) 292-1191
Interoperability endpoints
- marina.kamyshin.1@8042.direct.athenahealth.com
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.
-
- Obstetrics & Gynecology Physician
- Houston, TX
- NPI 1578969465
-
- Interventional Pain Medicine Physician
- San Antonio, TX
- NPI 1457167033
-
- Family Medicine Physician
- Sacramento, CA
- NPI 1083722516
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- Houston, TX
- NPI 1144203662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1467601930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8000 RESEARCH FOREST DR STE 360",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773821559",
"telephone_number": "281-292-1191",
"fax_number": "281-362-9170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8000 RESEARCH FOREST DR STE 360",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "77382",
"telephone_number": "281-292-1191"
}
],
"practiceLocations": [
{
"address_1": "3441 Marysville Blvd",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "95838",
"country_code": "US",
"telephone_number": "916-563-7234",
"fax_number": "916-679-5958",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAMYSHIN",
"first_name": "MARINA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-09",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA13007",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA19875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.