Individual provider Active NPI

Shiney Koshy, D.O.

  • Hospitalist Physician
  • Sugar Land, TX
National Provider Identifier
1881983054
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
R6595 Issued in TX
Practice address
17500 W Grand Pkwy S
Sugar Land, TX 77479-2562
Phone
(281) 725-5026
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 276670 NY
Internal Medicine Physician 207R00000X R6595 TX
Hospitalist Physician 208M00000X R6595 TX Primary

Addresses

Primary practice location

17500 W Grand Pkwy S
Sugar Land, TX 77479-2562

Mailing address

909 Frostwood Dr Ste 1.100
Houston, TX 77024-2301
Phone (713) 338-6353

Other identifiers 1

IdentifierTypeStateIssuer
04381040MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180424001778 TX Practitioner - HospitalistPractitioner - Internal Medicine 3779886387 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group Internal Medicine CurrentSince Sep 9, 2019 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

909 Frostwood Dr
Fl 1
Houston, TX 77024

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1881983054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 FROSTWOOD DR STE 1.100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242301",
            "telephone_number": "713-338-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 W GRAND PKWY S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792562",
            "telephone_number": "281-725-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "SHINEY",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276670",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R6595",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R6595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04381040",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.