Individual provider Active NPI

Ahmed Nezar Shobassy, M.D.

  • Gastroenterology Physician
  • Round Rock, TX
National Provider Identifier
1013132000
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M6395 Issued in TX
Practice address
300 University Blvd BLDG a
Round Rock, TX 78665-1032
Phone
(512) 509-0200
Fax
(512) 509-2229
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME99678 FL
Gastroenterology Physician 207RG0100X MD034817 DC
Gastroenterology Physician 207RG0100X M6395 TX Primary

Addresses

Primary practice location

300 University Blvd BLDG a
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

1690 Dunlawton Ave Ste 210
Port Orange, FL 32127-8980
Phone (386) 763-4920

Other identifiers 1

IdentifierTypeStateIssuer
2793369 00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashobassy612816@direct.sw.org Direct

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
I20110314000368 TX Practitioner - Gastroenterology 6709975303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Texas Medical School at Houston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

2600 E Pflugerville Pkwy
Pflugerville, TX 78660-5999

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

302 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy123
Upper gastrointestinal (GI) endoscopy for acid reflux118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD034817DCMDGastroenterology Physician
M6395TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Dec 27, 2019 Accepting new patients
Scott & White Clinic CurrentSince Dec 27, 2019 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Halifax Healthcare Systems Inc Gastroenterology Past Accepting new patients
Shobassy G.I.,P.a. Gastroenterology PastSince Feb 1, 2011 Accepting new patients

Locations

10815 Ranch Road 2222
Ste A-100
Austin, TX 78730
Phone (512) 327-4262

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

302 University Blvd
Round Rock, TX 78665
Phone (512) 218-6330

300 University Blvd
Bldg A
Round Rock, TX 78665
Phone (512) 509-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: ashobassy612816@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1602806400000",
    "number": "1013132000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD BLDG A",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200",
            "fax_number": "512-509-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1690 Dunlawton Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321278980",
            "country_code": "US",
            "telephone_number": "386-763-4920",
            "fax_number": "386-763-4939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOBASSY",
        "first_name": "AHMED",
        "middle_name": "NEZAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME99678",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "DC",
            "license": "MD034817",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "M6395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2793369 00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashobassy612816@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 University Blvd Bldg A",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.