ACTIVE LIFE HEALTH OF WEBSTER PLLC — NPI 1396537916 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine in WEBSTER, TX)

CMS-1500 Box 24J / 33a • NPI

1396537916

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208VP0000X (CMS 72)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine

Box 32 Service Location & ZIP+4

251 W MEDICAL CENTER BLVD STE 230, WEBSTER, TX, 77598-4242

✓ 9-Digit EDI 837 ZIP+4 (77598-4242)

Practice Phone & Referral Fax

(281) 603-9200

Fax: (281) 205-3502

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1396537916 (ACTIVE LIFE HEALTH OF WEBSTER PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1396537916` (NPI-2 Organization / Facility)
Provider / Legal Name	ACTIVE LIFE HEALTH OF WEBSTER PLLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine NUCC Code: `208VP0000X` (N/A)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	251 W MEDICAL CENTER BLVD STE 230, WEBSTER, TX, 77598-4242
Practice Telephone / Fax	Tel: (281) 603-9200 \| Fax: (281) 205-3502
Administrative Mailing Address	251 W MEDICAL CENTER BLVD STE 230, WEBSTER, TX, 77598-4242
Enumeration & Last Sync	Enumerated: 2025-05-20 \| CMS Record Updated: 2026-05-19
Authorized Official	JOHN RUSH (Owner of the entity)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

251 W MEDICAL CENTER BLVD STE 230, WEBSTER, TX, 77598-4242

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Plain-English Taxonomy & CMS Crosswalk (208VP0000X)

What Does Taxonomy Code 208VP0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208VP0000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 72 (Physician/Pain Management)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ACTIVE LIFE HEALTH OF WEBSTER PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208100000X` — Physical Medicine & Rehabilitation Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation	State: N/A \| License: `Verified` \| Primary: Secondary
`208VP0000X` — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ACTIVE LIFE HEALTH OF WEBSTER PLLC (NPI #1396537916)