Individual provider Active NPI

Fereshteh Golchin

  • Physical Therapy Assistant
  • Katy, TX
National Provider Identifier
1861146664
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2037497 Issued in TX
Practice address
23960 Katy Fwy Ste 100
Katy, TX 77494-0893
Phone
(281) 644-7880
Fax
(281) 644-7888
NPI assigned
Feb 9, 2022
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2037497 TX Primary

Addresses

Primary practice location

23960 Katy Fwy Ste 100
Katy, TX 77494-0893

Mailing address

23960 Katy Fwy Ste 100
Katy, TX 77494-0893
Phone (281) 644-7880

Other identifiers 1

IdentifierTypeStateIssuer
00619417OtherTXDRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2037497TXMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Health System PastSince Feb 13, 2022 Accepting new patients

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, 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": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1861146664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23960 KATY FWY STE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774940893",
            "telephone_number": "281-644-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23960 KATY FWY STE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774940893",
            "telephone_number": "281-644-7880",
            "fax_number": "281-644-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLCHIN",
        "first_name": "FERESHTEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2037497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "00619417",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.