Individual provider Active NPI

Alisha Danielle Prystowsky, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1679079289
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T8312 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2399
Phone
(832) 824-1000
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X T8312 TX
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X T8312 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2399

Mailing address

4740 S I 10 Service Rd W Ste 120
Metairie, LA 70001-1214
Phone (504) 988-5458

Other practice location 1

1514 Jefferson Hwy
Jefferson, LA 70121-2429
Phone (866) 624-7637

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
I20250507001630 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 5496009425 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Pediatrics CurrentSince Apr 13, 2025 Accepting new patients
University Healthcare System, L.C. Past Accepting new patients

Locations

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1679079289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 S I 10 SERVICE RD W STE 120",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011214",
            "telephone_number": "504-988-5458",
            "fax_number": "504-988-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "866-624-7637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRYSTOWSKY",
        "first_name": "ALISHA",
        "middle_name": "DANIELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "T8312",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T8312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.