Individual provider Active NPI

Nikola Gajic, M.D.

  • Family Medicine Physician
  • Humble, TX
National Provider Identifier
1619021383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0036 Issued in TX
Practice address
8067 FM 1960 Rd E
Humble, TX 77346-1764
Phone
(281) 812-5418
Fax
(281) 812-5458
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K0036 TX Primary

Addresses

Primary practice location

8067 FM 1960 Rd E
Humble, TX 77346-1764

Mailing address

8067 FM 1960 Rd E
Humble, TX 77346-1764
Phone (281) 812-5418

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
I20120917000384 TX Practitioner - Family Practice 6204084262 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0036TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Houston Family Medicine PLLC Family Medicine CurrentSince Mar 14, 2018 Accepting new patients
Cypresswood Physicians PLLC Past Accepting new patients

Locations

2400 FM 1488 Rd
Ste 400
Conroe, TX 77384
Phone (832) 410-8389

8067 FM 1960 Rd E
Humble, TX 77346
Phone (281) 812-5418

8901 FM 1960 Bypass Rd W
Ste 202
Humble, TX 77338

8901 FM 1960 Bypass Rd W
Ste 308
Humble, TX 77338
Phone (281) 312-8540

2950 Cullen Blvd
Ste 101
Pearland, TX 77584
Phone (281) 977-7444

24540 FM 1314 Rd
Porter, TX 77365
Phone (281) 354-4009

151 Cypresswood Dr
Spring, TX 77388
Phone (832) 286-1664

25312 Interstate 45 N
Ste A
The Woodlands, TX 77386
Phone (832) 261-4808

25510 Interstate 45 N
The Woodlands, TX 77386
Phone (281) 419-1330

Interoperability endpoints

  • Direct secure messaging: nikola.gajic.10@11939.direct.athenahealth.com
  • Direct secure messaging: nikola.gajic.2@11939.direct.athenahealth.com
  • Direct secure messaging: nikola.gajic.8@11939.direct.athenahealth.com
  • Direct secure messaging: nikola.gajic.9@11939.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619021383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8067 FM 1960 RD E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773461764",
            "telephone_number": "281-812-5418",
            "fax_number": "281-812-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8067 FM 1960 RD E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773461764",
            "telephone_number": "281-812-5418",
            "fax_number": "281-812-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJIC",
        "first_name": "NIKOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.