Husein Imtiaz Poonawala, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

S2148 Issued in TX

Practice address

3051 Churchill Dr Ste 116
Flower Mound, TX 75022-5900

Phone

(469) 846-8346

Fax

(469) 409-0001

NPI assigned

Apr 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, TX2 enrollments

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 2

Specialty

Interventional RadiologyAlso: Peripheral Vascular Disease

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GJFFCD/Endpoint/GJFFCD

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.

• The Vein Clinic of Dallas LLC

  • Vascular & Interventional Radiology Physician
  • Flower Mound, TX
  • NPI 1760011308
  Medicare reassignment NPD Authorized official
• Dal Post Acute Partners, PLLC

  dba Accura Health MC

  • Internal Medicine Physician
  • Richardson, TX
  • NPI 1174298350
  Medicare reassignment NPD
• Red River Consultants, Inc

  • Diagnostic Radiology Physician
  • Shreveport, LA
  • NPI 1902877426
  Medicare reassignment NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1302912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1275823890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 CHURCHILL DR STE 116",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750225900",
            "telephone_number": "469-846-8346",
            "fax_number": "469-409-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 CHURCHILL DR STE 116",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750225900",
            "telephone_number": "469-846-8346",
            "fax_number": "469-409-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POONAWALA",
        "first_name": "HUSEIN",
        "middle_name": "IMTIAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-16",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301098227",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "S2148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Ponomarenko, D.C.
• Poonam Rai LLC (Elite Dental)
• Shawne Poplar, MA LPC
• Mary Vivian Porter, LCSW LPC
• Grace Powers
• Prairie Creek Counseling, PLLC
• Prairie Health Services, LLP (Prairie Imaging)

• Vascular & Interventional Radiology Physician in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Vascular & Interventional Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.