Individual provider Active NPI

Anil Samoilenko Menon, M.D.

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1922130590
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N4584 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-7885
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N4584 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

6431 Fannin
JJL 270
Houston, TX 77030
Phone (713) 500-7885

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
I20101028001091 TX Practitioner - Emergency Medicine 9739244583 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Stanford University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

5656 Kelley St
Houston, TX 77026-1967
Phone (713) 566-5000

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N4584TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Emergency Medicine CurrentSince Mar 1, 2012 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2016 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2016 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Aug 15, 2011 Accepting new patients
Ut Physicians CurrentSince Mar 1, 2012 Accepting new patients
Phalarope Inpatient Services, a Medical Corporation PastSince Mar 1, 2018 Accepting new patients
California Em-I Medical Services, a Medical Corporation Emergency Medicine Past Accepting new patients

Locations

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

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

6431 Fannin St
#270
Houston, TX 77030
Phone (713) 500-7878

6414 Fannin St
Ste G150
Houston, TX 77030
Phone (713) 486-7560

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

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 7

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1922130590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN",
            "address_2": "JJL 270",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-7885",
            "fax_number": "713-500-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "ANIL",
        "middle_name": "SAMOILENKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-02-04",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N4584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.