Individual provider Active NPI

Negin Pahlavan

  • Clinical Psychologist
  • Fort Sam Houston, TX
National Provider Identifier
1104258292
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37363 Issued in TX
Practice address
3100 Schofield Rd
Fort Sam Houston, TX 78234-7577
Phone
(210) 808-6798
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37363 TX Primary
Forensic Psychologist 103TF0200X

Addresses

Primary practice location

3100 Schofield Rd
Fort Sam Houston, TX 78234-7577

Mailing address

3100 Schofield Rd
Fort Sam Houston, TX 78234-7577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209000711 TX Practitioner - Clinical Psychologist 5890075824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37363TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 1, 2023 Accepting new patients
Therapy South - Opelika LLC PastSince Jan 1, 2019 Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

1430 Empire Central Dr
Dallas, TX 75247
Phone (214) 645-8500

Organizations & group practices 4

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1104258292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SCHOFIELD RD",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SCHOFIELD RD",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347577",
            "telephone_number": "210-808-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAHLAVAN",
        "first_name": "NEGIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37363",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.