NPIMap

Individual provider Active NPI

Ume-Haney Y. Kakwan, M.D.

  • Family Medicine Physician
  • Bryan, TX
National Provider Identifier
1699761536
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L1903 Issued in TX
Practice address
1612 W Villa Maria Rd Ste 130
Bryan, TX 77807-2310
Phone
(979) 690-4836
Fax
(979) 690-4837
NPI assigned
Sep 26, 2005
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L1903 TX Primary

Addresses

Primary practice location

1612 W Villa Maria Rd Ste 130
Bryan, TX 77807-2310

Mailing address

1612 W Villa Maria Rd Ste 130
Bryan, TX 77807-2310
Phone (979) 690-4836

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
I20120924000807 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 2860640430 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

1612 W Villa Maria Rd
Suite 130
Bryan, TX 77807-2310
Phone (979) 690-4836

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jul 1, 2018 Accepting new patients
St. Joseph Regional Health Center Family Medicine CurrentSince Mar 1, 2017 Accepting new patients
Vpa of Texas PLLC Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
St Joseph Regional Health Center CurrentSince Mar 1, 2017 Accepting new patients
Texas Avenue Medical Clinic Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
The Suchowiecky Center Past Accepting new patients
College Station Hospital LP Past Accepting new patients
St Joseph Physician Associates Family Medicine Past Accepting new patients

Locations

1612 W Villa Maria Rd
Ste 130
Bryan, TX 77807
Phone (979) 690-4836

1703 E 29th St
Bryan, TX 77802
Phone (979) 779-4756

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDFCBA
  • Direct secure messaging: ukakwan457177@direct.stlukeshealth.org
  • Direct secure messaging: umehaney.kakwan@sjrhc.eclinicaldirectplus.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1699761536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 W VILLA MARIA RD STE 130",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778072310",
            "telephone_number": "979-690-4836",
            "fax_number": "979-690-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 W VILLA MARIA RD STE 130",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778072310",
            "telephone_number": "979-690-4836",
            "fax_number": "979-690-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKWAN",
        "first_name": "UME-HANEY",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.