Individual provider Active NPI

Varshasb Broumand, M.D.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1154329720
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
M8559 Issued in TX
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

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
196155901MedicaidTX

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
I20080424000121 TX Practitioner - NephrologyPractitioner - Internal Medicine 8325139124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
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 28 clinicians

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 Dialysis facility, San Antonio, TX, CCN 742549
  • USRC Dialysis at Home West TCU Dialysis facility, San Antonio, TX, CCN 742581
  • North Central Kidney Disease Center Dialysis facility, San Antonio, TX, CCN 452811
  • Christus Santa Rosa Medical Center Hospital, San Antonio, TX, CCN 450237
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8559TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Reza Mizani, M.D., P.a. Nephrology CurrentSince Mar 1, 2008 Accepting new patients
M. Reza Mizani, M.D., P.a. CurrentSince Mar 1, 2008 Accepting new patients
M. Reza Mizani, M.D., P.a. Nephrology Past Accepting new patients
Nephrology Center of Maryland, PA Nephrology PastSince Jun 19, 2010 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

  • FHIR API: https://api.platform.athenahealth.com/7494/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 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.

Hospital & facility affiliations 7

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": "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

Verify at the official NPI Registry.