Organization Active NPI

Shah N. Afridi, M.D., P.a.

  • Internal Medicine Physician
  • Victoria, TX
National Provider Identifier
1164610481
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SHAH N. AFRIDI, M.D., P.A.
Practice address
2705 Hospital Dr
Ste. 101
Victoria, TX 77901-5775
Phone
(361) 574-1720
Fax
(361) 574-1721
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Authorized official

Name
Dr. Shah N. Afridi, M.D.NPI 1912919952
Title
Owner/ President
Phone
(361) 574-1720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2705 Hospital Dr
Ste. 101
Victoria, TX 77901-5775

Mailing address

2705 Hospital Dr
Ste. 101
Victoria, TX 77901-5775
Phone (361) 574-1720

Other identifiers 1

IdentifierTypeStateIssuer
030351301MedicaidTX

Other names 1

  • Shah N. Afridi, M.D., P.A. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000491 TX Part B Supplier - Clinic/Group Practice 9436290442 Receives reassigned benefits from 1 practitioner
Practice locations: Victoria, TX

National Provider Directory

National Provider Directory

Locations

2705 Hospital Dr
Ste 101
Victoria, TX 77901
Phone (361) 574-1720

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1164610481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE. 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1720",
            "fax_number": "361-574-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE. 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1720",
            "fax_number": "361-574-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAH N. AFRIDI, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "AFRIDI",
        "authorized_official_first_name": "SHAH",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "361-574-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030351301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shah N. Afridi, M.D., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.