Organization Active NPI

Clear Lake Physicians, PLLC

  • Nephrology Physician
  • Webster, TX
National Provider Identifier
1861970758
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CLEAR LAKE PHYSICIANS, PLLC
Practice address
500 W Medical Center Blvd
Webster, TX 77598-4220
Phone
(281) 942-8001
Fax
(281) 724-1919
NPI assigned
Aug 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Nadia Niazi, MDNPI 1801117296
Title
Member / Manager
Phone
(646) 404-3018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

500 W Medical Center Blvd
Webster, TX 77598-4220

Mailing address

PO Box 57907
Webster, TX 77598-7907
Phone (281) 942-8001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181010003522 TX Part B Supplier - Clinic/Group Practice 5395097869 Receives reassigned benefits from 1 practitioner
Practice locations: Webster, TX; Houston, TX; Texas City, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1861970758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57907",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775987907",
            "telephone_number": "281-942-8001",
            "fax_number": "281-724-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984220",
            "telephone_number": "281-942-8001",
            "fax_number": "281-724-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "NIAZI",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "MEMBER / MANAGER",
        "authorized_official_telephone_number": "646-404-3018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.