NPIMap

Individual provider Active NPI

Banafsheh Moshiree Thomas, M.D.

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1205833365
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q4814 Issued in TX
Practice address
801 Conover Dr
Grand Prairie, TX 75051-1519
Phone
(214) 266-3400
Fax
(214) 266-3499
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q4814 TX Primary
Family Medicine Physician 207Q00000X ME88476 FL

Addresses

Primary practice location

801 Conover Dr
Grand Prairie, TX 75051-1519

Mailing address

801 Conover Dr
Grand Prairie, TX 75051-1519
Phone (214) 266-3400

Other identifiers 1

IdentifierTypeStateIssuer
269727100MedicaidFL

Other names 1

  • Banafsheh Moshiree Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031216000205 FL Practitioner - Family Practice 2365349602 Reassigns benefits to 1 organization
I20160506000659 TX Practitioner - Family Practice 2365349602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

4201 Brook Spring Dr
BLDG I
Dallas, TX 75224-4968
Phone (214) 266-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q4814TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Mar 30, 2016 Accepting new patients
Rural Health Care Incorporated CurrentSince Apr 15, 2013 Accepting new patients
Rural Health Care, Inc. CurrentSince Apr 15, 2013 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District Family Medicine CurrentSince Mar 30, 2016 Accepting new patients

Locations

100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595

1302 River St
Palatka, FL 32177
Phone (386) 328-0108

4201 Brook Spring Dr
Bldg I
Dallas, TX 75224
Phone (214) 266-1450

801 Conover Dr
Grand Prairie, TX 75051
Phone (214) 266-3400

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: bmoshireethomas65399@direct.phhs.org

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 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1205833365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CONOVER DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511519",
            "telephone_number": "214-266-3400",
            "fax_number": "214-266-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 CONOVER DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750511519",
            "telephone_number": "214-266-3400",
            "fax_number": "214-266-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHIREE THOMAS",
        "first_name": "BANAFSHEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q4814",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME88476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269727100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BANAFSHEH",
            "last_name": "MOSHIREE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.