Individual provider Active NPI

Lawrence J. Cisek, PHD

  • Pediatric Urology Physician
  • Houston, TX
National Provider Identifier
1659455616
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
L0774 Issued in TX
Practice address
6410 Fannin St Ste 950
Houston, TX 77030-5204
Phone
(832) 325-7323
Fax
(713) 512-2221
NPI assigned
Oct 25, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Urology Physician 2088P0231X L0774 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 950
Houston, TX 77030-5204

Mailing address

6431 Fannin St.
MSB 5.220
Houston, TX 77030
Phone (713) 500-7425

Other identifiers 2

IdentifierTypeStateIssuer
144363209MedicaidTX
144363208MedicaidTX

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
I20080825000361 TX Practitioner - UrologyPractitioner - Pediatric Medicine 0749355816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0774TXMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jan 2, 2017 Accepting new patients
Ut Physicians CurrentSince Jan 2, 2017 Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste 950
Houston, TX 77030
Phone (832) 325-7234

6431 Fannin St
#5220
Houston, TX 77030

6431 Fannin St
#5242
Houston, TX 77030

8810 Highway 6
Ste 100
Sienna Plantation, TX 77459
Phone (713) 486-1200

Interoperability endpoints

  • Direct secure messaging: lcisek13043@direct.uth.org

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659455616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST.",
            "address_2": "MSB 5.220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-7425",
            "fax_number": "713-500-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305204",
            "telephone_number": "832-325-7323",
            "fax_number": "713-512-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISEK",
        "first_name": "LAWRENCE",
        "middle_name": "J.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "TX",
            "license": "L0774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144363209",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144363208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.