Individual provider Active NPI

Maria Luisa Ciccarello, ACNP-BC

  • Critical Care Medicine Nurse Practitioner
  • Houston, TX
National Provider Identifier
1528467438
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
AP129826 Issued in TX
Practice address
6624 Fannin St
Houston, TX 77030-2312
Phone
(713) 442-0000
NPI assigned
Aug 15, 2014
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 889624 TX
Acute Care Nurse Practitioner 363LA2100X AP129826 TX
Critical Care Medicine Nurse Practitioner 363LC0200X AP129826 TX Primary

Addresses

Primary practice location

6624 Fannin St
Houston, TX 77030-2312

Mailing address

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

Other practice location 1

6720 Bertner Ave
Houston, TX 77030-2604
Phone (823) 355-2666

Other identifiers 1

IdentifierTypeStateIssuer
356490804MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mciccarello29570@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160426000232 TX Practitioner - Nurse Practitioner 5496077497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

6624 Fannin St
Houston, TX 77030-2312
Phone (713) 442-0000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
889624TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Aug 19, 2019 Accepting new patients
Baylor College of Medicine CurrentSince Nov 1, 2018 Accepting new patients
Baylor College of Medicine CurrentSince Nov 1, 2018 Accepting new patients

Locations

20207 Chasewood Park Dr
Ste 300
Houston, TX 77070
Phone (832) 534-7800

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

6624 Fannin St
Houston, TX 77030
Phone (713) 442-1500

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

6720 Bertner Ave
Ste O520
Houston, TX 77030
Phone (832) 355-2202

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

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

11511 Shadow Creek Pkwy
Fl 1
Pearland, TX 77584

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1528467438",
    "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": "6624 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-442-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6720 Bertner Ave",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302604",
            "country_code": "US",
            "telephone_number": "823-355-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCARELLO",
        "first_name": "MARIA",
        "middle_name": "LUISA",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "889624",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP129826",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "AP129826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356490804",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mciccarello29570@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6624 Fannin St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770302312",
            "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",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6624 Fannin St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770302312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.