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NOAH KAI COLLACO
NPI 1619595204
General Practice in Houston, TX

Active since July 09, 2020PECOS Enrolled
3914 GRAMERCY ST, HOUSTON, TX 77025(713) 888-0881 Get Directions Write a Review

NPPES record last updated: July 12, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 12, 2025, Jul 9, 2020 (2 updates tracked since 2020).

About Noah Kai Collaco NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOAH KAI COLLACO (NPI 1619595204) is an individual general practice provider in Houston, Texas, licensed in Texas (V9871) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1619595204
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameNOAH KAI COLLACO
Location Address3914 GRAMERCY STHouston, TX 77025-1107
Mailing Address3914 Gramercy St Ste AHouston, TX 77025-1107
Phone(713) 888-0881
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 9, 2020
Last NPPES UpdateJuly 12, 20252 updates tracked since enumeration
NPPES CertifiedJuly 12, 2025
✔ NPI 1619595204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in TX · V9871
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3914 GRAMERCY ST, Houston, TX 77025
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Noah Kai Collaco is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668966896
PECOS Enrollment IDI20251215001765
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GENA LISTER CASTILLA N.P.
Nurse Practitioner (Family)
3914 GRAMERCY ST
HOUSTON, TX 77025
Harris County (713) 888-0881
DR. CHRISTOPHER R. COLLACO M.D.
Allergy & Immunology
3914 GRAMERCY ST, SUITE A
HOUSTON, TX 77025
Harris County (713) 888-0881

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Noah Collaco's NPI number?

The NPI number for Noah Collaco is 1619595204. It was assigned to this individual provider in the NPPES registry on July 9, 2020.

Where is Noah Collaco located?

Noah Collaco practices at 3914 Gramercy St, Houston, TX 77025. The listed phone number is (713) 888-0881.

What is Noah Collaco's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Noah Collaco enrolled in Medicare?

Yes. Noah Collaco is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Noah Collaco was last updated on July 12, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.