Individual provider Active NPI

Kelly Umholtz, AA-C

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1720346539
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-6200
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

4747 Bellaire Blvd Ste 580
Bellaire, TX 77401-4535
Phone (713) 659-3284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120727000464 TX Practitioner - Anesthesiology Assistant 4183880669 Reassigns benefits to 1 organization
I20230216000448 DC Practitioner - Anesthesiology Assistant 4183880669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1133 21St St NW
Medstar at Lafayette Centre
Washington, DC 20036-3390
Phone (202) 416-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jan 2, 2023 Accepting new patients
Ut Physicians CurrentSince Jun 18, 2012 Accepting new patients
Ut Physicians CurrentSince Jun 18, 2012 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jan 2, 2023 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

1133 21st St NW
Washington, DC 20036
Phone (202) 223-9040

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

5410 West Loop S
Bellaire, TX 77401
Phone (713) 314-4444

4747 Bellaire Blvd
Ste 580
Bellaire, TX 77401
Phone (713) 659-3284

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

921 Gessner Rd
Ste 226
Houston, TX 77024
Phone (713) 242-3439

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 6

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1720346539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 BELLAIRE BLVD STE 580",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014535",
            "telephone_number": "713-659-3284",
            "fax_number": "713-664-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMHOLTZ",
        "first_name": "KELLY",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.