Individual provider Active NPI

Mahta Amidi, MD

  • Neurology Physician
  • Dallas, TX
National Provider Identifier
1255079703
Registry record updated May 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
1025886 Issued in MA
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8000
NPI assigned
May 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 1025886 MA Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

3663 Cedar Springs Rd Apt 405
Dallas, TX 75219-5060
Phone (217) 714-0433

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Other practice location 2

55 Fruit St
Boston, MA 02114-2696
Phone (617) 726-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1025886MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1255079703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 CEDAR SPRINGS RD APT 405",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752195060",
            "telephone_number": "217-714-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMIDI",
        "first_name": "MAHTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "1025886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.