Individual provider Active NPI

Susan Badidi, MD

  • Family Medicine Physician
  • Breckenridge, TX
National Provider Identifier
1184989642
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q5745 Issued in TX
Practice address
101 S Hartford St
Breckenridge, TX 76424-4711
Phone
(254) 559-3363
Fax
(254) 559-2572
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5745 TX Primary

Addresses

Primary practice location

101 S Hartford St
Breckenridge, TX 76424-4711

Mailing address

101 S Hartford St
Breckenridge, TX 76424-4711
Phone (254) 559-3363

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
I20160130000031 TX Practitioner - Family Practice 8224331913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

3200 W Euless Blvd
Euless, TX 76040-6253
Phone (817) 702-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5745TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Oct 21, 2019 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

3200 W Euless Blvd
Euless, TX 76040
Phone (817) 702-3000

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

Interoperability endpoints

  • Direct secure messaging: sbadidi74562@direct.jpshealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1184989642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S HARTFORD ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244711",
            "telephone_number": "254-559-3363",
            "fax_number": "254-559-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S HARTFORD ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244711",
            "telephone_number": "254-559-3363",
            "fax_number": "254-559-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADIDI",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, TX

Sources for this page

Verify at the official NPI Registry.