Individual provider Active NPI

Kelly Nguyen Santesteban, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1699798397
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6949TG Issued in TX
Practice address
15655 Cypress Wood Medical Dr
Suite 100
Houston, TX 77014-1471
Phone
(713) 442-1700
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6949TG TX Primary

Addresses

Primary practice location

15655 Cypress Wood Medical Dr
Suite 100
Houston, TX 77014-1471

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 1

IdentifierTypeStateIssuer
205354804MedicaidTX

Other names 1

  • Kelly Lan Nguyen Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksantesteban21392@direct.kelsey-seybold.com Direct
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070508000072 TX Practitioner - Optometry 9335245364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

15655 Cypress Wood Medical Dr
Suite 100
Houston, TX 77014-1487
Phone (713) 442-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6949TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Sep 26, 2016 Accepting new patients
K S Management Services LLC Past Accepting new patients

Locations

15655 Cypress Wood Medical Dr
Ste 100
Houston, TX 77014
Phone (713) 442-1700

15655 Cypress Wood Medical Dr
Houston, TX 77014
Phone (713) 442-1700

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: ksantesteban21392@direct.kelsey-seybold.com

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1699798397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15655 CYPRESS WOOD MEDICAL DR",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770141471",
            "telephone_number": "713-442-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTESTEBAN",
        "first_name": "KELLY",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6949TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205354804",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksantesteban21392@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15655 Cypress Wood Medical Dr",
            "address_2": "Suite 100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770141471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15655 Cypress Wood Medical Dr",
            "address_2": "Suite 100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770141471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "NGUYEN",
            "middle_name": "LAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.