Individual provider Active NPI

Monica Kodakandla

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1881042463
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R5416 Issued in TX
Practice address
6431 Fannin St
Suite MSB 3.151
Houston, TX 77030-1501
Phone
(713) 500-5800
Fax
(713) 500-5805
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X R5416 TX Primary

Addresses

Primary practice location

6431 Fannin St
Suite MSB 3.151
Houston, TX 77030-1501

Mailing address

6431 Fannin St
Suite MSB 3.151
Houston, TX 77030-1501

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Monica.Kodakandla@direct.memorialhermann.org Memorial Hermann Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190819001173 TX Practitioner - Pediatric Medicine 7810225661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Ut Physicians CurrentSince Jul 1, 2019 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

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

6431 Fannin St
Ste Msb
Houston, TX 77030
Phone (713) 500-5800

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

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

Interoperability endpoints

  • Direct secure messaging: monica.kodakandla@direct.memorialhermann.org

Organizations & group practices 3

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1881042463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE MSB 3.151",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "SUITE MSB 3.151",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-5800",
            "fax_number": "713-500-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODAKANDLA",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R5416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Monica.Kodakandla@direct.memorialhermann.org",
            "affiliation": "Y",
            "affiliationName": "Memorial Hermann Medical Group",
            "address_1": "909 Frostwood Dr.",
            "address_2": "Suite 1.100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770242301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.