Individual provider Active NPI

Rauvan Averick, MD

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1801871603
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q1352 Issued in TX
Practice address
921 Gessner Rd
Houston, TX 77024-2501
Phone
(888) 279-4504
NPI assigned
Dec 14, 2005
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 154708 NY
Internal Medicine Physician 207R00000X 154708 NY
Emergency Medicine Physician 207P00000X Q1352 TX Primary

Addresses

Primary practice location

921 Gessner Rd
Houston, TX 77024-2501

Mailing address

1 Edgewater St
Suite 723
Staten Island, NY 10305-4900
Phone (718) 226-1013

Other identifiers 2

IdentifierTypeStateIssuer
01069158MedicaidNY
348310906MedicaidTX

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
I20150526000256 TX Practitioner - Emergency Medicine 6507950870 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Hospital Based Physician Group Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Feb 19, 2018 Accepting new patients

Locations

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

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

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 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1801871603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "SUITE 723",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-1013",
            "fax_number": "718-226-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GESSNER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242501",
            "telephone_number": "888-279-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERICK",
        "first_name": "RAUVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "154708",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "154708",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q1352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01069158",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348310906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.