Individual provider Active NPI

Suzanne M. Condron, MD

  • Pediatrics Physician
  • Sugar Land, TX
National Provider Identifier
1528049293
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L9153 Issued in TX
Practice address
11555 University Blvd
Sugar Land, TX 77478-3889
Phone
(713) 442-9100
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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 L9153 TX Primary

Addresses

Primary practice location

11555 University Blvd
Sugar Land, TX 77478-3889

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 1

IdentifierTypeStateIssuer
350506701MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address scondron13344@direct.kelsey-seybold.com Direct
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20050617000844 TX Practitioner - Pediatric Medicine 5496799678 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9153TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Jul 28, 2014 Accepting new patients

Locations

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

11555 University Blvd
Sugar Land, TX 77478
Phone (713) 442-9100

Interoperability endpoints

  • Direct secure messaging: scondron13344@direct.kelsey-seybold.com

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1528049293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 UNIVERSITY BLVD",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783889",
            "telephone_number": "713-442-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDRON",
        "first_name": "SUZANNE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L9153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350506701",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scondron13344@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11555 University Blvd",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774783889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11555 University Blvd",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774783889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.