Individual provider Active NPI

Krish Keerthan Manisundaram, MD

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1992565832
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
125.083723 Issued in IL
Practice address
1 Baylor PLZ
Houston, TX 77030-3411
Phone
(713) 798-4951
NPI assigned
Mar 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 125.083723 IL Primary

Addresses

Primary practice location

1 Baylor PLZ
Houston, TX 77030-3411

Mailing address

1 Baylor PLZ
Houston, TX 77030-3411
Phone (713) 798-4951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241008000018 IL Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 3072044676

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992565832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "713-798-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "713-798-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANISUNDARAM",
        "first_name": "KRISH",
        "middle_name": "KEERTHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "125.083723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.