NPIMap

Individual provider Active NPI

Mehdi Nouri Kolouri, M.D

  • Nephrology Physician
  • Houston, TX
National Provider Identifier
1467689190
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A140205 Issued in CA
Practice address
6620 Main St Ste 11D32.5
Baylor College of Medicine
Houston, TX 77030-2348
Phone
(713) 798-5808
NPI assigned
Jun 20, 2009
Last updated
Aug 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A140205 CA Primary

Addresses

Primary practice location

6620 Main St Ste 11D32.5
Baylor College of Medicine
Houston, TX 77030-2348

Mailing address

20911 Earl St
Ste 200
Torrance, CA 90503-4353
Phone (310) 886-9642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005002702 CA Practitioner - Nephrology 2668606930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Advanced Kidney Solutions IncGroup PAC ID 0547556003, 4 clinicians

Practice addresses (Care Compare)

20911 Earl St
Suite 200
Torrance, CA 90503-4353
Phone (310) 488-4232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140205CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Firooz Pak MD Inc Nephrology CurrentSince Aug 8, 2016 Accepting new patients
Pacific Advanced Kidney Solutions Inc CurrentSince Aug 8, 2016 Accepting new patients

Locations

8540 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90045
Phone (310) 568-8938

20911 Earl St
Ste 200
Torrance, CA 90503
Phone (310) 214-3278

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.

Hospital & facility affiliations 8

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": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1467689190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 EARL ST",
            "address_2": "STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034353",
            "telephone_number": "310-886-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 MAIN ST STE 11D32.5",
            "address_2": "BAYLOR COLLEGE OF MEDICINE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302348",
            "telephone_number": "713-798-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURI KOLOURI",
        "first_name": "MEHDI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-20",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A140205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.