Organization Active NPI

Iman Ali MD PA

  • Specialist
  • Bedford, TX
National Provider Identifier
1225218381
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
IMAN ALI MD PA
Practice address
2036 Bedford Rd
Bedford, TX 76021-5709
Phone
(817) 685-8018
Fax
(817) 685-9484
NPI assigned
Nov 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Iman H Ali, MDNPI 1164466272
Title
Physician/Officer
Phone
(817) 685-8018

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2036 Bedford Rd
Bedford, TX 76021-5709

Mailing address

2036 Bedford Rd
Bedford, TX 76021-5709
Phone (817) 685-8018

Other identifiers 2

IdentifierTypeStateIssuer
2017774MedicaidTX
00458MOtherTXMEDICARE GROUP PTAN NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000744 TX Part B Supplier - Clinic/Group Practice 5991871212 Receives reassigned benefits from 1 practitioner
Practice locations: Bedford, TX

National Provider Directory

National Provider Directory

Locations

2036 Bedford Rd
Bedford, TX 76021
Phone (817) 685-8018

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": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1225218381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 BEDFORD RD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215709",
            "telephone_number": "817-685-8018",
            "fax_number": "817-685-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 BEDFORD RD",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215709",
            "telephone_number": "817-685-8018",
            "fax_number": "817-685-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAN ALI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "IMAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN/OFFICER",
        "authorized_official_telephone_number": "817-685-8018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017774",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN NUMBER",
            "identifier": "00458M",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.