NPIMap

Individual provider Active NPI

Clyde Leland Corey, M.D.

  • Urology Physician
  • Tomball, TX
National Provider Identifier
1942288394
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
H4250 Issued in TX
Practice address
919 Graham Dr
Tomball, TX 77375-6408
Phone
(281) 516-6530
Fax
(281) 290-9824
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 208800000-UROLOGY TX
Urology Physician 208800000X H4250 TX Primary

Addresses

Primary practice location

919 Graham Dr
Tomball, TX 77375-6408

Mailing address

919 Graham Dr
Tomball, TX 77375-6408
Phone (281) 516-6530

Other identifiers 1

IdentifierTypeStateIssuer
096750701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000783 TX Practitioner - UrologyPractitioner - General Surgery 4486676632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Regional Urology, PLLCGroup PAC ID 9335310267, 5 clinicians

Practice addresses (Care Compare)

201 Kingwood Medical Dr
Suite B300
Kingwood, TX 77339-6017
Phone (281) 570-1391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208800000-UROLOGYTXMDUrology Physician
H4250TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomball Surgery Center, LP PastSince Apr 12, 2004 Accepting new patients
Northwoods Urology Association Past Accepting new patients
Northwoods Urology Association Past Accepting new patients
Steven W Sukin MD PA Urology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clyde.corey.1@32499.direct.athenahealth.com
  • Direct secure messaging: clyde.corey.p1@direct.mphcc.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1942288394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 GRAHAM DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756408",
            "telephone_number": "281-516-6530",
            "fax_number": "281-290-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 GRAHAM DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756408",
            "telephone_number": "281-516-6530",
            "fax_number": "281-290-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "CLYDE",
        "middle_name": "LELAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "208800000-UROLOGY",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "H4250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096750701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.