Individual provider Active NPI

Sherine Samuel Bennikutty, APRN

  • Family Nurse Practitioner
  • Katy, TX
National Provider Identifier
1487240297
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1003139 Issued in TX
Practice address
4302 Lasker Brook CT
Katy, TX 77494-1427
Phone
(346) 978-3044
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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 1003139 TX Primary

Addresses

Primary practice location

4302 Lasker Brook CT
Katy, TX 77494-1427

Mailing address

4302 Lasker Brook CT
Katy, TX 77494-1427
Phone (346) 978-3044

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
I20210217001916 TX Practitioner - Nurse Practitioner 4082029491 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Practice House Calls LLC Family CurrentSince Jan 1, 2021 Accepting new patients
Advance Pharmacy LLC Past Accepting new patients

Locations

2646 S Loop W
Ste 330
Houston, TX 77054
Phone (281) 888-4407

Interoperability endpoints

  • Direct secure messaging: sherine.bennikutty.p1@direct.wthc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1487240297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 LASKER BROOK CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941427",
            "telephone_number": "346-978-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 LASKER BROOK CT",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941427",
            "telephone_number": "346-978-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNIKUTTY",
        "first_name": "SHERINE",
        "middle_name": "SAMUEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1003139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.