Active NPI
Jacob T Kuruvila, PA-C
- Physician Assistant
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA06597
- Practice address
- 1515 Holcombe Blvd
Houston, TX 77030-4009 - Phone
- (713) 792-6161
- NPI assigned
- Dec 3, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA06597 | TX | |
| Surgical Physician Assistant | 363AS0400X | 013727-1 | NY | |
| Surgical Physician Assistant | 363AS0400X | PA06597 | TX | |
| Physician Assistant | 363A00000X | PA06597 | TX | Primary |
Addresses
Primary practice location
1515 Holcombe Blvd
Houston, TX 77030-4009
Mailing address
P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991
Other practice location 1
6400 Fannin St
Ut Medical School Suite 2800
Houston, TX 77030-1521
Phone (713) 500-6134
Other practice location 2
1515 Holcombe Blve
Houston, TX 77030-4009
Phone (713) 792-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214721706 | Medicaid | TX |
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, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2130 W Holcombe Blvd
Univ of TX M D Ande Life Sciences Plaza
Houston, TX 77030-4009
Phone (713) 592-5433
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.29 of 100
- Quality
- 70.82
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 67.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013727-1 | NY | MD | Surgical Physician Assistant |
| PA06597 | TX | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Physicians | Current | Accepting new patients | |
| Ut Physicians | Physician Assistant | Current | Accepting new patients |
| MHS Physicians of Texas | Past | Accepting new patients |
Locations
6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714
1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446
6400 Fannin St
Ste 2800
Houston, TX 77030
Phone (713) 704-7100
1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446
18955 N Memorial Dr
Ste 360
Humble, TX 77338
Phone (281) 319-8530
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Houston, TX
- NPI 1073574810
-
- Health Educator
- Houston, TX
- NPI 1316534472
-
- Neurological Surgery Physician
- Shenandoah, TX
- NPI 1184714867
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1174582050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1497083364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 4439",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104439",
"telephone_number": "713-792-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304009",
"telephone_number": "713-792-6161"
}
],
"practiceLocations": [
{
"address_1": "6400 Fannin St",
"address_2": "UT MEDICAL SCHOOL SUITE 2800",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770301521",
"country_code": "US",
"telephone_number": "713-500-6134",
"fax_number": "713-500-0548",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1515 Holcombe Blve",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770304009",
"country_code": "US",
"telephone_number": "713-792-6161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KURUVILA",
"first_name": "JACOB",
"middle_name": "T",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-03",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA06597",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "013727-1",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "PA06597",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA06597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "214721706",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.