NPIMap

Organization Active NPI

Kingwood Physician Group PLLC

  • Emergency Medicine Physician
  • Kingwood, TX
National Provider Identifier
1871210138
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
KINGWOOD PHYSICIAN GROUP PLLC
Practice address
23330 Highway 59 N
Kingwood, TX 77339-4471
Phone
(832) 653-3200
Fax
(832) 653-2978
NPI assigned
Oct 26, 2022
Last updated
Nov 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Authorized official

Name
Santosh Dixit, DONPI 1033444245
Title
Owner/President
Phone
(512) 791-3198

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
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

23330 Highway 59 N
Kingwood, TX 77339-4471

Mailing address

911 San Marino St
Sugar Land, TX 77478-3329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230406002382 TX Part B Supplier - Clinic/Group Practice 4183099005 Receives reassigned benefits from 12 practitioners
Practice locations: Kingwood, TX

National Provider Directory

National Provider Directory

Locations

23330 Highway 59 N
Kingwood, TX 77339
Phone (832) 653-3200

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1871210138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SAN MARINO ST",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23330 HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394471",
            "telephone_number": "832-653-3200",
            "fax_number": "832-653-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGWOOD PHYSICIAN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "DIXIT",
        "authorized_official_first_name": "SANTOSH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-791-3198",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.