NPIMap

Individual provider Active NPI

Roussel Clement, MD

  • Internal Medicine Physician
  • Groves, TX
National Provider Identifier
1710977913
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L5284 Issued in TX
Practice address
6265 39TH St
Groves, TX 77619-4614
Phone
(409) 962-4400
Fax
(409) 962-4412
NPI assigned
Oct 27, 2005
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L5284 TX Primary

Addresses

Primary practice location

6265 39TH St
Groves, TX 77619-4614

Mailing address

6265 39TH St
Groves, TX 77619-4614
Phone (409) 962-4400

Other identifiers 2

IdentifierTypeStateIssuer
155554203MedicaidTX
TXB143105MedicaidTX

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
I20050112000741 TX Practitioner - Internal MedicinePractitioner - General PracticePractitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Pain ManagementPractitioner - Addiction Medicine 8628027026 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine, Family Practice, General Practice, Hospice/Palliative Care
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roussel Clement MD PAGroup PAC ID 4486655446, 2 clinicians

Practice addresses (Care Compare)

11850 Bissonnet St
Suite Z
Houston, TX 77099-1995
Phone (832) 596-7142

6265 39TH St
Groves, TX 77619-4614
Phone (409) 962-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shalom Health Care Management LLC CurrentSince Dec 14, 2022 Accepting new patients
Paramount MD PA CurrentSince Jan 7, 2022 Accepting new patients
Dynamic Anesthesia Providers PLLC Internal Medicine CurrentSince Apr 1, 2021 Accepting new patients
Paramount MD PA Internal Medicine CurrentSince Jan 7, 2022 Accepting new patients
Bright Health Physician Associates CurrentSince Jun 1, 2025 Accepting new patients
Ess of Nacogdoches LLC CurrentSince Aug 1, 2021 Accepting new patients
Ess of Port Lavaca LLC CurrentSince Aug 1, 2021 Accepting new patients
Priority Wound Care LLC CurrentSince Apr 1, 2025 Accepting new patients
Michael G Keller DO PA Internal Medicine Past Accepting new patients
Hsa Port Arthur, LLC Past Accepting new patients
Gulf Coast Health Center, Inc PastSince Aug 10, 2018 Accepting new patients
Post Acute Enterprises, L.L.C. Past Accepting new patients
Internal Medicine Associates LLP Internal Medicine Past Accepting new patients
Everest Primary Care MD PA PastSince Jan 1, 2021 Accepting new patients
Christus Health Southeast Texas Past Accepting new patients
The Medical Center of Southeast Texas LP Past Accepting new patients

Locations

85 Interstate 10 N
Ste 110
Beaumont, TX 77707
Phone (409) 853-1885

950 Washington Blvd
Beaumont, TX 77705
Phone (409) 554-8060

11850 Bissonnet St
Ste Z
Houston, TX 77099
Phone (281) 372-6892

1500 S Dairy Ashford Rd
Ste 200
Houston, TX 77077
Phone (281) 208-7414

4615 Southwest Fwy
Ste 850
Houston, TX 77027
Phone (281) 475-4428

6830 E Sam Houston Pkwy N
Ste 100B
Houston, TX 77049
Phone (409) 853-1885

137 N Lhs Dr
Lumberton, TX 77657
Phone (409) 284-9717

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

1431 S Highway 69
Nederland, TX 77627
Phone (409) 540-9418

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

26710 Interstate 45
Ste B
Spring, TX 77386
Phone (281) 419-1117

Interoperability endpoints

  • Direct secure messaging: roussel.clement@eucl-tx.direct.office.nextgen.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ability HospiceWebster, TX, CCN 971749 Hospice Contracted Managing Employee May 27, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 12

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1710977913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6265 39TH ST",
            "city": "GROVES",
            "state": "TX",
            "postal_code": "776194614",
            "telephone_number": "409-962-4400",
            "fax_number": "409-962-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6265 39TH ST",
            "city": "GROVES",
            "state": "TX",
            "postal_code": "776194614",
            "telephone_number": "409-962-4400",
            "fax_number": "409-962-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "ROUSSEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L5284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155554203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TXB143105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groves, TX

Sources for this page

Verify at the official NPI Registry.