Individual provider Active NPI

Anisha Roveena Nguyen, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1609240944
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10152 Issued in TX
Practice address
7200 Cambridge St FL 10
Houston, TX 77030-4202
Phone
(713) 798-1750
Fax
(713) 798-4693
NPI assigned
Nov 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10152 TX Primary

Addresses

Primary practice location

7200 Cambridge St FL 10
Houston, TX 77030-4202

Mailing address

7200 Cambridge St FL 10
Houston, TX 77030-4202
Phone (713) 798-1750

Other practice location 1

Ear, Nose and Throat Clinic
301 University Blvd
Galveston, TX 77555-1329
Phone (409) 772-1011

Other names 1

  • Anisha Roveena Prabakaran Former name

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
I20210713000150 TX Practitioner - Physician Assistant 9739516600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1977 Butler Blvd
Houston, TX 77030-4101

1977 Butler Boulevard
Houston, TX 77030-4101

1977 Butler Boulevard 6TH Floor
200 BCM Physicians
Houston, TX 77030-4101
Phone (713) 798-6131

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 1, 2021 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2021 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients
Upmc Community Medicine Inc Past Accepting new patients
Utmb Faculty Group Practice PastSince Oct 13, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

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

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

1977 Butler Blvd
Ste E5100
Houston, TX 77030
Phone (713) 798-3200

Organizations & group practices 6

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.

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": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1609240944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST FL 10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST FL 10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-4693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ear, Nose and Throat Clinic",
            "address_2": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775551329",
            "country_code": "US",
            "telephone_number": "409-772-1011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANISHA",
        "middle_name": "ROVEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANISHA",
            "last_name": "PRABAKARAN",
            "middle_name": "ROVEENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.