Individual provider Active NPI

Rediet B Araya, PAC

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1891006763
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
13415 Woodforest Blvd
Houston, TX 77015-2922
Phone
(713) 453-9400
Fax
(713) 453-9402
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20852 CA
Medical Physician Assistant 363AM0700X TX Primary

Addresses

Primary practice location

13415 Woodforest Blvd
Houston, TX 77015-2922

Mailing address

6245 Renwick Dr Apt 4202
Houston, TX 77081-3803
Phone (562) 310-1270

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
I20121030000275 TX Practitioner - Physician Assistant 9133379068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6910 Bellaire Blvd
Suite 14
Houston, TX 77074-3547
Phone (713) 271-2129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20852CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
L G Solutions Co. PL PastSince Apr 1, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8719/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1891006763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 RENWICK DR APT 4202",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770813803",
            "telephone_number": "562-310-1270",
            "fax_number": "713-453-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13415 WOODFOREST BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770152922",
            "telephone_number": "713-453-9400",
            "fax_number": "713-453-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAYA",
        "first_name": "REDIET",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20852",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.