Individual provider Active NPI

Iyad K Radwan, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Katy, TX
National Provider Identifier
1750673901
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
N9481 Issued in TX
Practice address
411 Park Grove
Suite #620
Katy, TX 77450-1576
Phone
(832) 645-4038
Fax
(832) 675-9861
NPI assigned
May 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X N9481 TX
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X N9481 TX Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X N9481 TX

Addresses

Primary practice location

411 Park Grove
Suite #620
Katy, TX 77450-1576

Mailing address

P.O. Box 42453
Houston, TX 77242-2453
Phone (832) 620-3282

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
I20120112000151 TX Practitioner - Thoracic SurgeryPractitioner - General PracticePractitioner - Critical Care (Intensivists) 9638346810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Critical Care (Intensivists), General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Texas Limited PartnershipGroup PAC ID 6608868070, shared by 9 NPIs, 91 clinicians

Practice addresses (Care Compare)

13440 University Blvd
Suite 210
Sugar Land, TX 77479-4909
Phone (281) 277-1330

411 Park Grove Dr
Suite 620
Katy, TX 77450-1576
Phone (832) 645-4038

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N9481TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iyad K. Radwan, MD., PA Critical Care Medicine CurrentSince Feb 9, 2012 Accepting new patients

Locations

411 Park Grove Dr
Ste 620
Katy, TX 77450
Phone (832) 645-4038

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1750673901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 42453",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772422453",
            "telephone_number": "832-620-3282",
            "fax_number": "832-675-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 PARK GROVE",
            "address_2": "SUITE #620",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501576",
            "telephone_number": "832-645-4038",
            "fax_number": "832-675-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADWAN",
        "first_name": "IYAD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-06",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "N9481",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "N9481",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "N9481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.