Individual provider Active NPI

Sadiya Hakim Jamal, D.O.

  • Pediatrics Physician
  • Shenandoah, TX
National Provider Identifier
1275888109
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P9204 Issued in TX
Practice address
106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone
(713) 442-1800
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P9204 TX Primary

Addresses

Primary practice location

106 Vision Park Blvd
Shenandoah, TX 77384-3000

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 1

IdentifierTypeStateIssuer
340524302MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address sjamal19035@direct.kelsey-seybold.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150908001354 TX Practitioner - Pediatric Medicine 7113233016 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Aug 24, 2015 Accepting new patients

Locations

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800

Interoperability endpoints

  • Direct secure messaging: sjamal19035@direct.kelsey-seybold.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1275888109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 VISION PARK BLVD",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843000",
            "telephone_number": "713-442-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMAL",
        "first_name": "SADIYA",
        "middle_name": "HAKIM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P9204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340524302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "106 Vision Park Blvd",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjamal19035@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "106 Vision Park Blvd",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.