Organization Active NPI

Mani K MD PA

  • Family Medicine Physician
  • Baytown, TX
National Provider Identifier
1720369473
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N7292 Issued in TX
Legal business name
MANI K MD PA
Practice address
2223 Rollingbrook Dr Ste 125
Baytown, TX 77521-3656
Phone
(281) 420-3565
Fax
(281) 427-7808
NPI assigned
Sep 7, 2011
Last updated
Jul 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Sepi Moghaddam
Title
Management
Phone
(281) 420-3565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X N7292 TX Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X N7292 TX

Addresses

Primary practice location

2223 Rollingbrook Dr Ste 125
Baytown, TX 77521-3656

Mailing address

2223 Rollingbrook Dr Ste 125
Baytown, TX 77521-3656
Phone (281) 420-3565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000839 TX Part B Supplier - Clinic/Group Practice 3375716582 Receives reassigned benefits from 3 practitioners
Practice locations: Baytown, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2056148Mani K MD PA2223 Rollingbrook Dr Suite 125, Baytown, TX 77521Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

2223 Rollingbrook Dr
Ste 125
Baytown, TX 77521
Phone (281) 420-3565

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1720369473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 ROLLINGBROOK DR STE 125",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213656",
            "telephone_number": "281-420-3565",
            "fax_number": "281-427-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 ROLLINGBROOK DR STE 125",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213656",
            "telephone_number": "281-420-3565",
            "fax_number": "281-427-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANI K MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "MOGHADDAM",
        "authorized_official_first_name": "SEPI",
        "authorized_official_title_or_position": "MANAGEMENT",
        "authorized_official_telephone_number": "281-420-3565"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N7292",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N7292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baytown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.