Individual provider Active NPI

Andrew C Koshy

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1861160905
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14861 Issued in TX
Practice address
1635 North Loop W
Houston, TX 77008-1532
Phone
(713) 867-2000
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14861 TX Primary

Addresses

Primary practice location

1635 North Loop W
Houston, TX 77008-1532

Mailing address

9351 Margail Ave
Des Plaines, IL 60016-4200
Phone (847) 962-0219

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL email Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210923003041 TX Practitioner - Physician Assistant 9436556008 Reassigns benefits to 2 organizations
I20260602001796 AZ Practitioner - Physician Assistant 9436556008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgicalist of TX PLLCGroup PAC ID 6800179292, 5 clinicians

Practice addresses (Care Compare)

2700 E 29TH St
Suite 305
Bryan, TX 77802-2587
Phone (979) 315-8122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14861TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Oct 1, 2021 Accepting new patients
Ut Physicians CurrentSince Oct 1, 2021 Accepting new patients

Locations

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Organizations & group practices 4

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.

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1861160905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9351 MARGAIL AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164200",
            "telephone_number": "847-962-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NORTH LOOP W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081532",
            "telephone_number": "713-867-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "ANDREW",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA14861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1635 North Loop W",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770081532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.