Individual provider Active NPI

Sairoz Mobh

  • Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1063131324
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP142641 Issued in TX
Practice address
710 E Pioneer Pkwy
Grand Prairie, TX 75051-4958
Phone
(972) 262-8211
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP142641 TX Primary

Addresses

Primary practice location

710 E Pioneer Pkwy
Grand Prairie, TX 75051-4958

Mailing address

406 Angela LN
Euless, TX 76039-3855

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
I20230127002620 TX Practitioner - Nurse Practitioner 3476924564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

710 E Pioneer Pkwy
Wellmed at Pioneer Parkway
Grand Prairie, TX 75051-4958
Phone (972) 262-8211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. CurrentSince Jan 30, 2023 Accepting new patients
Wellmed Medical Group, PA CurrentSince Jan 30, 2023 Accepting new patients
Affinity Heart Care, PA PastSince Aug 1, 2022 Accepting new patients

Locations

710 E Pioneer Pkwy
Grand Prairie, TX 75051
Phone (972) 262-8211

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: sairoz.mobh@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1063131324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ANGELA LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760393855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E PIONEER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514958",
            "telephone_number": "972-262-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBH",
        "first_name": "SAIROZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP142641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.