Individual provider Active NPI

Nebil Siraj Muktar

  • Physician Assistant
  • Richmond, TX
National Provider Identifier
1053020537
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16144 Issued in TX
Practice address
4828 Water View Town Center
Suite 100
Richmond, TX 77407
Phone
(281) 762-0355
NPI assigned
Nov 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16144 TX Primary

Addresses

Primary practice location

4828 Water View Town Center
Suite 100
Richmond, TX 77407

Mailing address

4828 Water View Town Center
Suite 100
Richmond, TX 77407
Phone (281) 762-0355

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009002438 TX Practitioner - Physician Assistant 8820529282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Urgent Care Clinic LLCGroup PAC ID 3971804188, 16 clinicians

Practice addresses (Care Compare)

12120 Jones Rd
Suite D
Houston, TX 77070-5280
Phone (832) 756-2125

4828 Waterview Town Ctr Dr
Suite 100
Richmond, TX 77407-2385
Phone (832) 427-6015

6111 N Fry Rd
Katy, TX 77449-5563
Phone (832) 913-6817

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Home Physicians PastSince Nov 27, 2022 Accepting new patients
L G Solutions Co. PL PastSince Apr 1, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8719/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1053020537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 WATER VIEW TOWN CENTER",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77407",
            "telephone_number": "281-762-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 WATER VIEW TOWN CENTER",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77407",
            "telephone_number": "281-762-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKTAR",
        "first_name": "NEBIL",
        "middle_name": "SIRAJ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.