Active NPI
Kelly W Rising, MD
- Obstetrics & Gynecology Physician
- Beaumont, TX
National Provider Identifier
1659365674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- J1129
- Practice address
- 755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501 - Phone
- (409) 899-1499
- Fax
- (409) 899-1354
- NPI assigned
- Sep 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | J1129 | TX | Primary |
Addresses
Primary practice location
755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501
Mailing address
755 N 11TH St
Suite P4200
Beaumont, TX 77702-1501
Phone (409) 899-1499
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124919502 | Medicaid | TX | |
| 160036971 | Other | TX | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2011 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Texas OB GYN Associates PA | Obstetrics & Gynecology | Past | Accepting new patients |
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.
-
- Obstetrics & Gynecology Physician
- Beaumont, TX
- NPI 1245361369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1659365674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 N 11TH ST",
"address_2": "SUITE P4200",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777021501",
"telephone_number": "409-899-1499",
"fax_number": "409-899-1354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 N 11TH ST",
"address_2": "SUITE P4200",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777021501",
"telephone_number": "409-899-1499",
"fax_number": "409-899-1354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISING",
"first_name": "KELLY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-06",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "J1129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124919502",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "160036971",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.