NPIMap

Individual provider Active NPI

Serge-Alain Awasum, MD

  • Gastroenterology Physician
  • Shenandoah, TX
National Provider Identifier
1164416608
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M2544 Issued in TX
Practice address
9200 Pinecroft Dr Ste 480
Shenandoah, TX 77380-3285
Phone
(281) 205-1111
Fax
(281) 419-2111
NPI assigned
Sep 9, 2005
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X M2544 TX Primary

Addresses

Primary practice location

9200 Pinecroft Dr Ste 480
Shenandoah, TX 77380-3285

Mailing address

134 Vision Park Blvd Ste 280
Shenandoah, TX 77384-3032
Phone (281) 205-1111

Other practice location 1

9851 FM 2097 West
Bldg 120, Ste G1
Willis, TX 77318
Phone (281) 205-1111

Other practice location 2

25329 Budde Rd Ste 104
The Woodlands, TX 77380-1697
Phone (327) 166-1198

Other identifiers 2

IdentifierTypeStateIssuer
179142802MedicaidTX
282148001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000490 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 6608896907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
East Tennessee State University Quillen College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Houston Digestive Disease ConsultantsGroup PAC ID 0446374060, 2 clinicians

Practice addresses (Care Compare)

9200 Pinecroft Dr
Suite 480
Shenandoah, TX 77380-3285
Phone (281) 205-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy61
Upper gastrointestinal (GI) endoscopy for acid reflux103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M2544TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Houston Digestive Disease Consultants Gastroenterology CurrentSince May 11, 2010 Accepting new patients
Sadler Clinic Association Past Accepting new patients
Endocentre at Quarterfield Station Past Accepting new patients
Digestive Disease Consultants PA Gastroenterology PastSince Dec 13, 2001 Accepting new patients
Woodholme Gastroenterology Assoc PA Gastroenterology Past Accepting new patients
Greater Houston Digestive Disease Consultants PastSince Apr 28, 2024 Accepting new patients

Locations

1120 Medical Plaza Dr
Ste 255
Shenandoah, TX 77380
Phone (281) 205-1111

134 Vision Park Blvd
Ste 280
Shenandoah, TX 77384
Phone (281) 205-1111

9200 Pinecroft Dr
Ste 480
Shenandoah, TX 77380
Phone (281) 205-1111

25329 Budde Rd
Ste 104
The Woodlands, TX 77380
Phone (832) 713-6119

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDFHBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDFHBA/Endpoint/FDFHBA

Organizations & group practices 6

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 10

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1164416608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 VISION PARK BLVD STE 280",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843032",
            "telephone_number": "281-205-1111",
            "fax_number": "281-419-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 PINECROFT DR STE 480",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803285",
            "telephone_number": "281-205-1111",
            "fax_number": "281-419-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9851 FM 2097 West",
            "address_2": "Bldg 120, Ste G1",
            "address_purpose": "LOCATION",
            "city": "Willis",
            "state": "TX",
            "postal_code": "77318",
            "country_code": "US",
            "telephone_number": "281-205-1111",
            "fax_number": "281-419-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25329 Budde Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "The Woodlands",
            "state": "TX",
            "postal_code": "773801697",
            "country_code": "US",
            "telephone_number": "327-166-1198",
            "fax_number": "281-809-6917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWASUM",
        "first_name": "SERGE-ALAIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "M2544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179142802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282148001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.