Individual provider Active NPI

Simon Kayyal, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1700028735
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q0657 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2608
Phone
(832) 824-1000
NPI assigned
Apr 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q0657 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2608

Mailing address

2 Greenway PLZ
Suite 300
Houston, TX 77046-0297
Phone (832) 828-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200303001823 CA Practitioner - Pediatric MedicinePractitioner - Neurology 2365757739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Neurology
Education
University of Texas Medical School at Houston, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (888) 770-2462

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Orange County Pediatrics CurrentSince Jan 7, 2020 Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients

Locations

500 Superior Ave
Ste 140
Newport Beach, CA 92663
Phone (949) 631-3603

505 S Main St
Ste 300
Orange, CA 92868
Phone (714) 509-7070

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1700028735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYYAL",
        "first_name": "SIMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q0657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.