NPIMap

Individual provider Active NPI

Alireza Behboudi, D.O.

  • Orthopaedic Surgery Physician
  • Tyler, TX
National Provider Identifier
1245302819
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
P0547 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954
Phone
(903) 596-3844
Fax
(903) 593-3843
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc. 375 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Suite 600
Tyler, TX 75701-1954
Phone (903) 596-3844

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Tyler, TX, CCN 459457
  • Choice Homecare Home health agency, Tyler, TX, CCN 458261
  • Ut Health East Texas Home Health Services Home health agency, Pittsburg, TX, CCN 677037
  • Ut Health East Texas Home Health Services Home health agency, Athens, TX, CCN 677586
  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
  • Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747
  • Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement19
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)34
Removal of tissue56
Removal of nail tissue1-10

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
I20120201000363 TX Practitioner - Orthopedic Surgery 6305962473 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P0547TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Starks Medical Past Accepting new patients
Health Services of Central Georgia, Inc PastSince Jun 1, 2004 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

700 Olympic Plaza Cir
Ste 600
Tyler, TX 75701
Phone (903) 594-2666

Interoperability endpoints

  • Direct secure messaging: abehboudi355749@ahs.direct-ci.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X P0547 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954

Mailing address

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954
Phone (903) 596-3844

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2020.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1245302819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844",
            "fax_number": "903-593-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844",
            "fax_number": "903-593-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHBOUDI",
        "first_name": "ALIREZA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "P0547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.