Individual provider Active NPI

Samir Atieh, MD

  • Family Medicine Physician
  • Wichita Falls, TX
National Provider Identifier
1306048715
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32233 Issued in KS
Practice address
1301 3Rd St
Wichita Falls, TX 76301-2245
Phone
(940) 767-5145
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32233 KS Primary

Addresses

Primary practice location

1301 3Rd St
Wichita Falls, TX 76301-2245

Mailing address

5402 Texas Star LN
Wichita Falls, TX 76310-3348
Phone (817) 229-4382

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
I20100121000395 TX Practitioner - Family PracticePractitioner - Internal Medicine 4082789813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Emergency Services Physician Group PAGroup PAC ID 0749447936, 71 clinicians

Practice addresses (Care Compare)

1500 S Main St
1St FL Outpatient
Ft. Worth, TX 76104-4917
Phone (817) 702-3431

1575 S Main St
JPS Emergency
Fort Worth, TX 76104-4901
Phone (817) 702-8828

Hospital & facility affiliations

  • JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32233KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
D&J Grace Team LLC Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
Integrative Emergency Services Physician Group PA CurrentSince Sep 9, 2013 Accepting new patients

Locations

921 FM 1187 E
Ste A
Crowley, TX 76036
Phone (817) 297-2000

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

6251 Oakmont Blvd
Ft Worth, TX 76132
Phone (682) 250-5700

1661 Eastchase Pkwy
Ft Worth, TX 76120
Phone (682) 250-5700

Interoperability endpoints

  • Direct secure messaging: samir.atieh.p1@direct.lbucc.nextgenshare.com

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306048715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 TEXAS STAR LN",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763103348",
            "telephone_number": "817-229-4382",
            "fax_number": "940-696-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 3RD ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763012245",
            "telephone_number": "940-767-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIEH",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "32233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.