Individual provider Active NPI

Khalid H Syed, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1003915802
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R1460 Issued in TX
Practice address
2332 Beverly Hills Dr
Fort Worth, TX 76114-1756
Phone
(817) 378-0855
Fax
(817) 378-0861
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R1460 TX Primary

Addresses

Primary practice location

2332 Beverly Hills Dr
Fort Worth, TX 76114-1756

Mailing address

2332 Beverly Hills Dr
Fort Worth, TX 76114-1756
Phone (817) 378-0855

Other identifiers 3

IdentifierTypeStateIssuer
01639270MedicaidNY
D93276OtherNYUPIN
374935001MedicaidTX

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
I20170802000346 TX Practitioner - Pediatric Medicine 6709044910 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Centers Pediatrics CurrentSince Jun 13, 2017 Accepting new patients
United Medical Centers Pediatrics CurrentSince Jun 13, 2017 Accepting new patients

Locations

2525 N Veterans Blvd
Eagle Pass, TX 78852
Phone (830) 773-5358

Interoperability endpoints

  • Direct secure messaging: khalid.syed.1@18152.direct.athenahealth.com
  • Direct secure messaging: khalid.syed@passaicpeds.eclinicaldirectplus.com

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1003915802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 BEVERLY HILLS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141756",
            "telephone_number": "817-378-0855",
            "fax_number": "817-378-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 BEVERLY HILLS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141756",
            "telephone_number": "817-378-0855",
            "fax_number": "817-378-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "KHALID",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R1460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01639270",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "D93276",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374935001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.