Individual provider Active NPI

Fahad Javed, M.D.,

  • Interventional Cardiology Physician
  • Conroe, TX
National Provider Identifier
1033425087
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
S0909 Issued in TX
Practice address
601 River Pointe Dr Ste 105
Conroe, TX 77304-2943
Phone
(936) 539-5577
Fax
(936) 539-5550
NPI assigned
Aug 27, 2010
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 266935 NY
Interventional Cardiology Physician 207RI0011X 26033 MS
Interventional Cardiology Physician 207RI0011X DR.0062918 CO
Interventional Cardiology Physician 207RI0011X S0909 TX Primary
Interventional Cardiology Physician 207RI0011X MD.206853 LA

Addresses

Primary practice location

601 River Pointe Dr Ste 105
Conroe, TX 77304-2943

Mailing address

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

Other practice location 1

1 Mercado St Ste 130
Durango, CO 81301-7306
Phone (970) 247-1120

Other practice location 2

4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211

Other practice location 3

102 Medical Park Ln Ste A
Huntsville, TX 77340-4975
Phone (936) 539-5577

Other practice location 4

4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211

Other identifiers 1

IdentifierTypeStateIssuer
E-12343OtherARLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191106001575 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 2668641317
I20200127002126 TX Practitioner - Internal Medicine 2668641317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arif Abdullah MD PAGroup PAC ID 8426157041, 4 clinicians
Cardiac Cath Lab of Conroe, LPGroup PAC ID 4789846262, 8 clinicians

Practice addresses (Care Compare)

102 Medical Park LN a
Huntsville, TX 77340-4975
Phone (936) 539-5577

17183 I 45
Suite 350
Shenandoah, TX 77385-3313
Phone (936) 321-0080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.42
Promoting interoperability
100
Improvement activities
40
Cost
77.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting32
Pacemaker insertion or repair26
Varicose vein removal32
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.206853LAMDInterventional Cardiology Physician
26033MSMDInterventional Cardiology Physician
S0909TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Cath Lab of Conroe, LP CurrentSince Nov 1, 2024 Accepting new patients
South Arkansas Physician Services LLC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Arif Abdullah MD PA CurrentSince May 1, 2024 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

620 W Grove St
Ste 202
El Dorado, AR 71730
Phone (870) 863-2420

601 River Pointe Dr
Ste 105
Conroe, TX 77304
Phone (936) 441-5550

102 Medical Park Ln
Ste A
Huntsville, TX 77340
Phone (936) 294-0971

17183 I 45 S
Ste 350
Shenandoah, TX 77385
Phone (936) 321-0080

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1033425087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012523",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RIVER POINTE DR STE 105",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042943",
            "telephone_number": "936-539-5577",
            "fax_number": "936-539-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Mercado St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813017306",
            "country_code": "US",
            "telephone_number": "970-247-1120",
            "fax_number": "970-247-1128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4215 15th St",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "39501",
            "country_code": "US",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Medical Park Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "TX",
            "postal_code": "773404975",
            "country_code": "US",
            "telephone_number": "936-539-5577",
            "fax_number": "936-539-5550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4215 15th St",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "39501",
            "country_code": "US",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVED",
        "first_name": "FAHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "266935",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "26033",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "DR.0062918",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "S0909",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "MD.206853",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E-12343",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.