NPIMap

Individual provider Active NPI

Samir Pradeep Shirodkar, MD

  • Urology Physician
  • The Woodlands, TX
National Provider Identifier
1679774459
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
N9644 Issued in TX
Practice address
9305 Pinecroft Dr
Suite 104
The Woodlands, TX 77380-3482
Phone
(936) 441-1005
Fax
(936) 521-1138
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X N9644 TX Primary

Addresses

Primary practice location

9305 Pinecroft Dr
Suite 104
The Woodlands, TX 77380-3482

Mailing address

9305 Pinecroft Dr
Suite 104
The Woodlands, TX 77380-3482
Phone (936) 441-1005

Other identifiers 2

IdentifierTypeStateIssuer
094010801OtherTXGROUP MEDICAID NUMBER
00J21AOtherTXGROUP MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000304 TX Practitioner - Urology 0244403178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Baylor College of Medicine, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

690 S Loop 336
Suite 200
Conroe, TX 77304-3320

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Aspire Hospital Hospital, Conroe, TX, CCN 670093
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122
  • HCA Houston Healthcare Conroe Hospital, Conroe, TX, CCN 450222
  • Huntsville Memorial Hospital Hospital, Huntsville, TX, CCN 450347
  • Memorial Hermann Hospital Inpatient rehabilitation facility, Houston, TX, CCN 45T184

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Creek Urology Specialists LLC Urology CurrentSince May 8, 2012 Accepting new patients
Yee Plastic Surgery, PLLC CurrentSince Jun 1, 2012 Accepting new patients

Locations

690 S Loop 336 W
Ste 200
Conroe, TX 77304
Phone (832) 262-0435

506 Medical Center Blvd
Ste 304
Conroe, TX 77304
Phone (855) 259-2872

1020 Riverwood Ct
Ste 330
Conroe, TX 77304
Phone (855) 259-2872

9201 Pinecroft Dr
Shenandoah, TX 77380
Phone (832) 246-8000

9305 Pinecroft Dr
Ste 104
The Woodlands, TX 77380
Phone (281) 896-0013

9305 Pinecroft Dr
Ste 304
The Woodlands, TX 77380
Phone (832) 510-6553

9305 Pinecroft Dr
Ste 303
The Woodlands, TX 77380
Phone (281) 943-2704

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.

Hospital & facility affiliations 12

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1679774459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 PINECROFT DR",
            "address_2": "SUITE 104",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803482",
            "telephone_number": "936-441-1005",
            "fax_number": "936-521-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 PINECROFT DR",
            "address_2": "SUITE 104",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803482",
            "telephone_number": "936-441-1005",
            "fax_number": "936-521-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRODKAR",
        "first_name": "SAMIR",
        "middle_name": "PRADEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "N9644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "094010801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "00J21A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.