Active NPI
Varshasb Broumand, M.D.
- Nephrology Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- M8559
- Practice address
- 215 N San Saba Ste 201
San Antonio, TX 78207-3120 - Phone
- (210) 547-3430
- Fax
- (210) 229-0606
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M8559 | TX | |
| Nephrology Physician | 207RN0300X | M8559 | TX | Primary |
Addresses
Primary practice location
215 N San Saba Ste 201
San Antonio, TX 78207-3120
Mailing address
PO Box 504152
Saint Louis, MO 63150-4152
Phone (210) 212-8622
Other practice location 1
215 N San Saba Ste 301
San Antonio, TX 78207-8101
Phone (210) 212-8622
Other practice location 2
12011 State Highway 151 Ste 202
San Antonio, TX 78251-1230
Phone (210) 265-8155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196155901 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080424000121 | TX | Practitioner - Nephrology | 8325139124 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- University of Miami, LM Miller School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- M Reza Mizani MD PA
Practice addresses (Care Compare)
12011 State Hwy 151
Suite 202
San Antonio, TX 78251-1233
Phone (210) 265-8155
12970 Toepperwein Rd
Suite 102
Live Oak, TX 78233-4768
Phone (210) 664-0717
2011 E Houston St
Suite 101a
San Antonio, TX 78202-2916
Phone (210) 226-1717
205 22ND St
Hondo, TX 78861-2520
Phone (210) 614-7900
215 N San Saba
Suite 301
San Antonio, TX 78207-3164
Phone (210) 212-8622
8115 Datapoint Dr
Suite 200
San Antonio, TX 78229-3745
Phone (210) 614-7900
Hospital & facility affiliations
- USRC Hill Country Dialysis
- USRC Dialysis at Home West TCU
- North Central Kidney Disease Center
- Christus Santa Rosa Medical Center
- Methodist Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8559 | TX | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M. Reza Mizani, M.D., P.a. | Nephrology | Current | Accepting new patients |
| M. Reza Mizani, M.D., P.a. | Current | Accepting new patients | |
| M. Reza Mizani, M.D., P.a. | Nephrology | Past | Accepting new patients |
| Nephrology Center of Maryland, PA | Nephrology | Past | Accepting new patients |
| Nephrology Associates of Northern Virginia, Inc | Nephrology | Past | Accepting new patients |
Locations
205 22nd St
Hondo, TX 78861
Phone (830) 426-2753
11212 State Highway 151
Ste 320
San Antonio, TX 78251
Phone (210) 951-8339
215 N San Saba
Ste 201
San Antonio, TX 78207
Phone (210) 547-3430
343 W Houston St
Ste 609
San Antonio, TX 78205
Phone (210) 212-4595
215 N San Saba
Ste 301
San Antonio, TX 78207
Phone (210) 212-8984
12011 State Highway 151
Ste 202
San Antonio, TX 78251
Phone (210) 265-8155
Interoperability endpoints
- https://api.platform.athenahealth.com/7494/brand/1/csg/1/fhir/r4
- varshasb.broumand@strcg.eclinicaldirectplus.com
Organizations & group practices 5
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.
-
- Ambulatory Surgical Clinic/Center
- San Antonio, TX
- NPI 1740700111
-
- Nephrology Physician
- Fairfax, VA
- NPI 1174541049
Nephrology
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Antonio, TX
- NPI 1528170412
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Antonio, TX
- NPI 1003422171
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Antonio, TX
- NPI 1427525385
Dialysis facility
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1194787218
Hospital
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1124074273
Hospital
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1689627655
Hospital
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1952348021
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1154329720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 504152",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631504152",
"telephone_number": "210-212-8622",
"fax_number": "210-212-9197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N SAN SABA STE 201",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073120",
"telephone_number": "210-547-3430",
"fax_number": "210-229-0606"
}
],
"practiceLocations": [
{
"address_1": "215 N San Saba Ste 301",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782078101",
"country_code": "US",
"telephone_number": "210-212-8622",
"fax_number": "210-212-9197",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12011 State Highway 151 Ste 202",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782511230",
"country_code": "US",
"telephone_number": "210-265-8155",
"fax_number": "210-477-2750",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROUMAND",
"first_name": "VARSHASB",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "M8559",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "M8559",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196155901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.