NPIMap

Organization Active NPI

Shibli Family Medicine and Obesity Clinic PLLC

  • Family Medicine Physician
  • Mesquite, TX
National Provider Identifier
1093478489
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SHIBLI FAMILY MEDICINE AND OBESITY CLINIC PLLC
Practice address
802 US Highway 80 E
Mesquite, TX 75149-1555
Phone
(469) 827-7300
Fax
(469) 202-0120
NPI assigned
Oct 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Urooj Shibli, MDNPI 1295901049
Title
Owner
Phone
(412) 378-0755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obesity Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0002X
Obesity Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083B0002X

Addresses

Primary practice location

802 US Highway 80 E
Mesquite, TX 75149-1555

Mailing address

5045 Mulholland Dr
Plano, TX 75074-7036
Phone (412) 378-0755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211220002399 TX Part B Supplier - Clinic/Group Practice 7113318577 Receives reassigned benefits from 4 practitioners
Practice locations: Mesquite, TX

National Provider Directory

National Provider Directory

Locations

802 US Highway 80 E
Mesquite, TX 75149
Phone (469) 556-7186

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1093478489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 MULHOLLAND DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747036",
            "telephone_number": "412-378-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 US HIGHWAY 80 E",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491555",
            "telephone_number": "469-827-7300",
            "fax_number": "469-202-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIBLI FAMILY MEDICINE AND OBESITY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "SHIBLI",
        "authorized_official_first_name": "UROOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-378-0755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.