Individual provider Active NPI

Preston M Ukoli, M.D.

  • Nephrology Physician
  • Brownsville, TX
National Provider Identifier
1962627026
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
J7705 Issued in TX
Practice address
1211 E Alton Gloor Blvd
Brownsville, TX 78526-3831
Phone
(956) 542-1655
Fax
(956) 542-1881
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X J7705 TX Primary

Addresses

Primary practice location

1211 E Alton Gloor Blvd
Brownsville, TX 78526-3831

Mailing address

1211 E Alton Gloor Blvd
Brownsville, TX 78526-3831
Phone (956) 542-1655

Other identifiers 1

IdentifierTypeStateIssuer
123912104MedicaidTX

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
I20131108001232 TX Practitioner - NephrologyPractitioner - Internal Medicine 0840201869 Practice locations: Brownsville, TX

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1211 E Alton Gloor Blvd
Brownsville, TX 78526-3831
Phone (956) 542-1655

2945 Central Blvd B
Brownsville, TX 78520-8958

Hospital & facility affiliations

National Provider Directory

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

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1962627026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 E ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263831",
            "telephone_number": "956-542-1655",
            "fax_number": "956-542-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 E ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263831",
            "telephone_number": "956-542-1655",
            "fax_number": "956-542-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UKOLI",
        "first_name": "PRESTON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "J7705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123912104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.