Individual provider Active NPI

Mariah Sirajuddin, PA-C, MPAS

  • Physician Assistant
  • Katy, TX
National Provider Identifier
1104364785
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10796 Issued in TX
Practice address
19121 W Little York Rd Ste B
Katy, TX 77449-5841
Phone
(713) 955-5200
NPI assigned
Feb 3, 2017
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 PA10796 TX Primary

Addresses

Primary practice location

19121 W Little York Rd Ste B
Katy, TX 77449-5841

Mailing address

19414 Maidenhair Fern Dr
Cypress, TX 77433-7991
Phone (281) 202-9290

Other names 1

  • Mariah Sirajuddin Professional name

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
I20220707000521 TX Practitioner - Physician Assistant 8527448604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zealth Care PLLCGroup PAC ID 7416189774, 3 clinicians

Practice addresses (Care Compare)

13406 Medical Complex Dr
Suite 200
Tomball, TX 77375-3359
Phone (281) 351-7127

19121 W Little York Rd
Suite B
Katy, TX 77449-5841
Phone (409) 996-9816

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mufaddal Medical Consulting PLLC PastSince Jun 21, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJJFCA/Endpoint/HJJFCA
  • Direct secure messaging: mariah.sirajuddin@zmc.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1104364785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19414 MAIDENHAIR FERN DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774337991",
            "telephone_number": "281-202-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19121 W LITTLE YORK RD STE B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774495841",
            "telephone_number": "713-955-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAJUDDIN",
        "first_name": "MARIAH",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "SIRAJUDDIN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.