Individual provider Active NPI

Shane Pahlavan, M.D.

  • Otolaryngology Physician
  • Houston, TX
National Provider Identifier
1124271689
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
DEA AR3354292 Issued in TX
Practice address
6550 Fannin St
Suite 1727
Houston, TX 77030-2717
Phone
(713) 798-7217
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X DEA AR3354292 TX Primary

Addresses

Primary practice location

6550 Fannin St
Suite 1727
Houston, TX 77030-2717

Mailing address

5220 W University Dr
Ste 150
McKinney, TX 75071-7418

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120423000219 TX Practitioner - Otolaryngology 6204097058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The ENT and Allergy Centers of Texas, PLLCGroup PAC ID 4385709054, 56 clinicians

Practice addresses (Care Compare)

5220 W University Dr
Suite 150
McKinney, TX 75071-7418
Phone (972) 984-1050

Hospital & facility affiliations

  • Baylor Scott and White Medical Center McKinney Hospital, MC Kinney, TX, CCN 670082

Merit-based Incentive Payment System (MIPS)

Final score
74.15 of 100Reported as individual
Quality
54.1
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DEA AR3354292TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard D Thrasher III MD PA Otolaryngology PastSince Jun 11, 2018 Accepting new patients

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 and National Provider Directory roles.

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1124271689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 W UNIVERSITY DR",
            "address_2": "STE 150",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST",
            "address_2": "SUITE 1727",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302717",
            "telephone_number": "713-798-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAHLAVAN",
        "first_name": "SHANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "DEA AR3354292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.