Individual provider Active NPI

Nikita Girish Khetan, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1689092124
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R2379 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-5586
Fax
(713) 500-5805
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X R2379 TX
Pediatrics Physician 208000000X R2379 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

6431 Fannin St
Suite MSB 3.151
Houston, TX 77030-1501
Phone (713) 500-5800

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
I20170803002946 TX Practitioner - Pediatric Medicine 8123399573 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

State licenses

LicenseStateTypeSpecialty
R2379TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Sep 1, 2017 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2017 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

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

6431 Fannin St
Ste Msb
Houston, TX 77030
Phone (713) 500-5800

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Organizations & group practices 3

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1689092124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE MSB 3.151",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-5800",
            "fax_number": "713-500-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-5586",
            "fax_number": "713-500-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETAN",
        "first_name": "NIKITA",
        "middle_name": "GIRISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R2379",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R2379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.