Individual provider Active NPI

Larry Puthenparambil, MD

  • Retina Specialist (Ophthalmology) Physician
  • Pearland, TX
National Provider Identifier
1679718506
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
P2345 Issued in TX
Practice address
8540 Broadway St Ste 210
Pearland, TX 77584-7710
Phone
(832) 727-1771
NPI assigned
Dec 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X P2345 TX Primary
Ophthalmology Physician 207W00000X P2345 TX

Addresses

Primary practice location

8540 Broadway St Ste 210
Pearland, TX 77584-7710

Mailing address

8540 Broadway St Ste 210
Pearland, TX 77584-7710
Phone (832) 727-1771

Other practice location 1

6565 West Loop S Ste 650
Bellaire, TX 77401-3505
Phone (713) 797-1010

Other identifiers 1

IdentifierTypeStateIssuer
301100908MedicaidTX

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
I20120802000552 TX Practitioner - Ophthalmology 4183870462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

8540 Broadway St
Pearland, TX 77584-7710
Phone (281) 886-3853

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

Merit-based Incentive Payment System (MIPS)

Final score
88.7 of 100Reported as group
Quality
93.47
Promoting interoperability
89
Improvement activities
40
Cost
78.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P2345TXMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Ophthalmology CurrentSince Jan 23, 2017 Accepting new patients
South Houston Retina Retina Specialist CurrentSince Jun 15, 2023 Accepting new patients
Eye Center of Texas LLP CurrentSince Apr 1, 2020 Accepting new patients
Jed Lee Howard PA PastSince Apr 1, 2020 Accepting new patients

Locations

6565 West Loop S
Ste 650
Bellaire, TX 77401

700 University Blvd
Galveston, TX 77550
Phone (281) 338-0829

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

4415 Crenshaw Rd
Pasadena, TX 77504
Phone (281) 998-0500

8540 Broadway St
Ste 210
Pearland, TX 77584
Phone (281) 866-3853

Interoperability endpoints

  • Direct secure messaging: larryputhenparambil@eyectrtx.direct.eyemdemr.com
  • Direct secure messaging: lputhenparambil@shr.intellechartdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1679718506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 BROADWAY ST STE 210",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847710",
            "telephone_number": "832-727-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 BROADWAY ST STE 210",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847710",
            "telephone_number": "832-727-1771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 West Loop S Ste 650",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774013505",
            "country_code": "US",
            "telephone_number": "713-797-1010",
            "fax_number": "713-357-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTHENPARAMBIL",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-05",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "P2345",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P2345",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301100908",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.