Individual provider Active NPI

Kaizeen Cyrus Mody, DO, MS

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1700379013
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U0401 Issued in TX
Practice address
424 Hahlo St
Houston, TX 77020-3022
Phone
(713) 674-3326
NPI assigned
Jun 11, 2018
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 U0401 TX Primary

Addresses

Primary practice location

424 Hahlo St
Houston, TX 77020-3022

Mailing address

424 Hahlo St
Houston, TX 77020-3022
Phone (713) 674-3326

Other identifiers 1

IdentifierTypeStateIssuer
20A17986OtherCAOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA

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
I20241017001588 TX Practitioner - Family Practice 2668877838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

424 Hahlo St
Houston, TX 77020-3022
Phone (713) 674-3326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
U0401TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Community Health Centers Inc Current Accepting new patients
Houston Community Health Centers, Inc. Family Medicine CurrentSince Jun 10, 2024 Accepting new patients

Locations

424 Hahlo St
Houston, TX 77020
Phone (713) 343-5511

5808 Airline Dr
Houston, TX 77076
Phone (713) 695-4013

Interoperability endpoints

  • Direct secure messaging: kmody73862@adventhealth.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1700379013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 HAHLO ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770203022",
            "telephone_number": "713-674-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HAHLO ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770203022",
            "telephone_number": "713-674-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "KAIZEEN",
        "middle_name": "CYRUS",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U0401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA",
            "identifier": "20A17986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.