Individual provider Active NPI

Wagih A Gendi, MD

  • Pediatrics Physician
  • Pasadena, TX
National Provider Identifier
1487603148
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J9680 Issued in TX
Practice address
1430 Pasadena Blvd
#A
Pasadena, TX 77502-2414
Phone
(713) 477-0400
Fax
(713) 477-2711
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J9680 TX Primary

Addresses

Primary practice location

1430 Pasadena Blvd
#A
Pasadena, TX 77502-2414

Mailing address

1430 Pasadena Blvd
# A
Pasadena, TX 77502-2414
Phone (713) 477-0400

Other identifiers 1

IdentifierTypeStateIssuer
133436904MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260416002295 TX Practitioner - Pediatric Medicine 2961978093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1430 Pasadena Blvd
Suite a
Pasadena, TX 77502-2414

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J9680TXMDPediatrics Physician

Organizations & group practices 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1487603148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 PASADENA BLVD",
            "address_2": "# A",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775022414",
            "telephone_number": "713-477-0400",
            "fax_number": "713-477-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 PASADENA BLVD",
            "address_2": "#A",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775022414",
            "telephone_number": "713-477-0400",
            "fax_number": "713-477-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDI",
        "first_name": "WAGIH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133436904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.