Alexander Yudovich, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q0389 Issued in TX

Practice address

4501 Groveway Dr
Houston, TX 77087-1122

Phone

(713) 644-1568

NPI assigned

May 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pediatrix Medical Group of Texas Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
  • NPI 1649377359

  Pediatrics

  Medicare reassignment NPD
• Chca Womans Hospital LP

  dba Woman'S Hospital of Texas

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1023065794
  NPD (past)

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1508125923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 GROVEWAY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770871122",
            "telephone_number": "713-644-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 GROVEWAY DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770871122",
            "telephone_number": "713-644-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDOVICH",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q0389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336920901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leon T Yuan, PHARM D
• Mike Nanyong Yuan, MD, PHD
• Xiaoying Yuan, LAC
• Beth Yudofsky, MD
• Stuart Yudofsky, MD
• Martin Yudovich, MD
• Stephanie Lennox Yudovich, LCSW
• Joyce Yue, MD
• Carrie Hau Lai Yuen, M.D.
• Jeffrey Yuen

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.