NPIMap

Individual provider Active NPI

Shehryar Khaliqdina, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1033640784
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U2896 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-8621
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43092 OK
Internal Medicine Physician 207R00000X MD2019-1066 NM
Internal Medicine Physician 207R00000X U2896 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

2508 Sanders CT
Bedford, TX 76021-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, OK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200910000875 NM Practitioner - Internal Medicine 1557635182 Reassigns benefits to 1 organization
I20240606004018 OK Practitioner - Internal Medicine 1557635182 Reassigns benefits to 1 organization
I20240820003551 TX Practitioner - Internal Medicine 1557635182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians
Comanche County Healthcare CorporationGroup PAC ID 0749192433, 125 clinicians

Practice addresses (Care Compare)

1500 S Main St
John Peter Smith Hospital
Fort Worth, TX 76104-4917
Phone (817) 702-3431

2400 Unser Blvd SE
Rust Medical Center
Rio Rancho, NM 87124-4740
Phone (505) 253-7878

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (580) 510-7037

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039
  • Memorial Health Hospital, Lawton, OK, CCN 370056
  • Texas Health Hospital Mansfield Hospital, Mansfield, TX, CCN 670309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2019-1066NMMDInternal Medicine Physician
U2896TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation CurrentSince May 21, 2024 Accepting new patients
Comanche County Healthcare CurrentSince May 21, 2024 Accepting new patients
Comanche County Healthcare Corporation Current Accepting new patients
Khaliqdina Healthworks PLLC Internal Medicine CurrentSince Dec 14, 2025 Accepting new patients
Presbyterian Healthcare Services Internal Medicine Past Accepting new patients
Tarrant County Hospital District Past Accepting new patients

Locations

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

Organizations & group practices 7

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1033640784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 SANDERS CT",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760211100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQDINA",
        "first_name": "SHEHRYAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "43092",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2019-1066",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U2896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.