Djillali Boudjenah, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

CS00211459 Issued in NM

Practice address

4425 Plano Pkwy Ste 1401
Carrollton, TX 75010-5036

Phone

(214) 888-7711

NPI assigned

Aug 30, 2006

Last updated

Aug 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, FL2 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

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djillali.boudjenah.1@26532.direct.athenahealth.com
• Direct secure messaging: djillali.boudjenah@hca7.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/10780/brand/1/csg/1/fhir/r4

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.

• Psych MD PLLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Carrollton, TX
  • NPI 1609240977
  Medicare reassignment NPD Authorized official
• Medical Experts of Texas, P.a.

  • Hospitalist Physician
  • Lewisville, TX
  • NPI 1730395989
  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984
  Medicare reassignment NPD
• Primary Care Medical Services of Poinciana Inc

  dba Osceola Community Health Services at Fortune Rd

  • Federally Qualified Health Center (FQHC)
  • Kissimmee, FL
  • NPI 1376093609
  Medicare reassignment NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Primary Care Medical Services of Poinciana Inc

  dba Osceola Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Kissimmee, FL
  • NPI 1407481039
  NPD
• Carrollton Springs, LLC

  dba Carrollton Springs

  • Psychiatric Hospital
  • Carrollton, TX
  • NPI 1134401466
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1083724256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867443",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750867443",
            "telephone_number": "214-888-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PLANO PKWY STE 1401",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750105036",
            "telephone_number": "214-888-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 Bill Beck Blvd",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347449516",
            "country_code": "US",
            "telephone_number": "407-943-8618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUDJENAH",
        "first_name": "DJILLALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "CS00211459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "ME130416",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Bon, LCSW
• Anthony Bonner, WSI
• Robert Neil Borkowski, D.D.S., M.S.
• Boso PA (Kang Dental)
• Christopher Bouchard, M.ED, LPC
• Madeline Lorraine Boutwell, OTD, OTR
• Summer Bowen
• Shannon Luttrell Bowling, PT
• Kelly Linders Boyer, M.S. CCC-A/SLP
• Brackets Dental PLLC

• Psychiatry Physician in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.