Individual provider Active NPI

Angelina Vishnyakova

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1750768438
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R7136 Issued in TX
Practice address
6431 Fannin St
Suite JJL 431
Houston, TX 77030
Phone
(713) 500-7878
NPI assigned
Apr 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X R7136 TX Primary

Addresses

Primary practice location

6431 Fannin St
Suite JJL 431
Houston, TX 77030

Mailing address

8333 Braesmain Dr Apt 1422
Houston, TX 77025-2951
Phone (469) 867-3570

Other practice location 1

6431 Fannin St
Suite JJL 431
Houston, TX 77030-1501
Phone (713) 500-7878

Other practice location 2

11800 Astoria Blvd
Houston, TX 77089-6041
Phone (469) 867-3570

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
I20180516000654 TX Practitioner - Emergency Medicine 9436413689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Hospital Based Physician GroupGroup PAC ID 4385075480, 272 clinicians

Practice addresses (Care Compare)

16100 S Fwy
Pearland, TX 77584-1895
Phone (713) 338-6565

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Hospital Based Physician Group Single Specialty CurrentSince Jul 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Single Specialty CurrentSince Apr 15, 2018 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

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

2555 Gulf Fwy S
League City, TX 77573
Phone (832) 932-9850

2555 Gulf Fwy S
#C1100
League City, TX 77573

2555 Gulf Fwy S
Ste C1100
League City, TX 77573
Phone (832) 932-9850

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

Organizations & group practices 3

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 6

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": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1750768438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 BRAESMAIN DR APT 1422",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770252951",
            "telephone_number": "469-867-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE JJL 431",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-7878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St",
            "address_2": "Suite JJL 431",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-7878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11800 Astoria Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770896041",
            "country_code": "US",
            "telephone_number": "469-867-3570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISHNYAKOVA",
        "first_name": "ANGELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R7136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.