Individual provider Active NPI

Aisha Eniola Tadese

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1871201079
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7877 Willow Chase Blvd
Houston, TX 77070-5934
Phone
(832) 869-4818
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7877 Willow Chase Blvd
Houston, TX 77070-5934

Mailing address

2811 Meadowgrass LN
Houston, TX 77082-1809
Phone (832) 638-8316

Other practice location 1

2811 Meadowgrass Ln
Houston, TX 77082-1809
Phone (832) 638-8316

Other practice location 2

23838 Highway 59 N
Kingwood, TX 77339-1531
Phone (832) 869-4818

Other practice location 3

902 Frostwood Dr Ste 201
Houston, TX 77024-2402
Phone (832) 869-4818

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230310000800 TX Practitioner - Physician Assistant 0446623581 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psychplus Medical Associates of Michigan, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aisha.tadese.1@13131.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1871201079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 MEADOWGRASS LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770821809",
            "telephone_number": "832-638-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7877 WILLOW CHASE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705934",
            "telephone_number": "832-869-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Meadowgrass Ln",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770821809",
            "country_code": "US",
            "telephone_number": "832-638-8316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23838 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773391531",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 Frostwood Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242402",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TADESE",
        "first_name": "AISHA",
        "middle_name": "ENIOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.