Individual provider Active NPI

Neethu Mohan Menon

  • Pediatric Hematology & Oncology Physician
  • Houston, TX
National Provider Identifier
1952664518
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
R7818 Issued in TX
Practice address
6655 Travis St Ste 400
Houston, TX 77030
Phone
(713) 500-8375
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R73275 AZ
Pediatric Hematology & Oncology Physician 2080P0207X R7818 TX Primary

Addresses

Primary practice location

6655 Travis St Ste 400
Houston, TX 77030

Mailing address

6655 Travis St Ste 400
Houston, TX 77030-1343
Phone (713) 500-8375

Other practice location 1

1501 N Campbell Ave
Tucson, AZ 85724-5073
Phone (520) 626-7944

Other identifiers 2

IdentifierTypeStateIssuer
392372403MedicaidTX
392372404OtherTXCSHCN TPI

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
I20181015000625 TX Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 0648522961 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73275AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 12, 2018 Accepting new patients
Physicians Referral Service CurrentSince Mar 10, 2020 Accepting new patients
Ut Physicians Pediatrics CurrentSince Sep 12, 2018 Accepting new patients
The University of Texas Health Science Center Houston Past Accepting new patients
The University of Texas Health Science Center at Houston Past Accepting new patients

Locations

7000 Fannin St
Ste 750
Houston, TX 77030
Phone (713) 500-6031

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

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

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

6655 Travis St
Ste 400
Houston, TX 77030
Phone (713) 500-8360

6410 Fannin St
Ste 824B
Houston, TX 77030

Interoperability endpoints

  • Direct secure messaging: nmenon13781@direct.uth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1952664518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 TRAVIS ST STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301343",
            "telephone_number": "713-500-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 TRAVIS ST STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857245073",
            "country_code": "US",
            "telephone_number": "520-626-7944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENON",
        "first_name": "NEETHU",
        "middle_name": "MOHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R73275",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "R7818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "392372403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN TPI",
            "identifier": "392372404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.