Individual provider Active NPI

Roger Nicome, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1710196266
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M6313 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2303
Phone
(832) 824-2271
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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 M6313 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2303

Mailing address

2 E Greenway PLZ
Suite 900
Houston, TX 77046-0297
Phone (713) 798-1750

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
I20070711000788 TX Practitioner - Pediatric Medicine 1153421730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Baylor College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

8611 N Mopac Expy
Austin, TX 78759-8319
Phone (832) 824-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6313TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Pediatrics CurrentSince Jun 19, 2020 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

1102 Bates Ave
#1450
Houston, TX 77030

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1710196266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E GREENWAY PLZ",
            "address_2": "SUITE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOME",
        "first_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M6313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.