Active NPI
Bayan Entezari
- Family Medicine Physician
- Corpus Christi, TX
National Provider Identifier
1295422467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BP10082886
- Practice address
- 2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804 - Phone
- (361) 902-4789
- NPI assigned
- Apr 19, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BP10082886 | TX | Primary |
Addresses
Primary practice location
2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804
Mailing address
2606 Hospital Blvd Ste B
Corpus Christi, TX 78405-1804
Phone (361) 902-4789
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628001798 | TX | Order and Referring Only - Family Practice | 4789042466 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1295422467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2606 HOSPITAL BLVD STE B",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784051804",
"telephone_number": "361-902-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2606 HOSPITAL BLVD STE B",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784051804",
"telephone_number": "361-902-4789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTEZARI",
"first_name": "BAYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-19",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "BP10082886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.