Individual provider Active NPI

Kruti Gandhi, PA-C, MPH

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1659619195
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08612 Issued in TX
Practice address
Derm Surgery 7515 Main Street #240
Houston, TX 77030
Phone
(713) 791-9966
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 PA08612 TX Primary

Addresses

Primary practice location

Derm Surgery 7515 Main Street #240
Houston, TX 77030

Mailing address

5441 Larkin St
Houston, TX 77007-1803
Phone (205) 567-8166

Other identifiers 2

IdentifierTypeStateIssuer
009661100MedicaidFL
PA08612OtherTXLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131007000599 FL Practitioner - Physician Assistant 2567696578 Reassigns benefits to 2 organizations
I20190822000647 TX Practitioner - Physician Assistant 2567696578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermsouth, PAGroup PAC ID 2961599931, 2 clinicians
Derm Surgery Associates P.a.Group PAC ID 9436124278, 24 clinicians

Practice addresses (Care Compare)

10970 Shadow Creek Pkwy
Suite 340
Pearland, TX 77584-0121
Phone (713) 340-0030

6700 W Loop S
Suite 500
Bellaire, TX 77401-4120
Phone 7137919966130

Merit-based Incentive Payment System (MIPS)

Final score
96.89 of 100Reported as individual
Quality
93.79
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Oct 5, 2015 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Oct 5, 2015 Accepting new patients
Derm Surgery Associates P.a. Past Accepting new patients

Locations

106 Boston Ave
Ste 105
Altamonte Springs, FL 32701
Phone (407) 807-6402

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1816 Salk Ave
Tavares, FL 32778
Phone (352) 343-2461

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1659619195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 LARKIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770071803",
            "telephone_number": "205-567-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DERM SURGERY 7515 MAIN STREET #240",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-791-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "KRUTI",
        "name_prefix": "Miss",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009661100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA08612",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.