Individual provider Active NPI

Mike M Bismar, MD

  • Gastroenterology Physician
  • Burleson, TX
National Provider Identifier
1306816392
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
L0986 Issued in TX
Practice address
11801 South Fwy Ste 140
Burleson, TX 76028-7021
Phone
(817) 551-6161
Fax
(817) 551-6177
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X L0986 TX Primary

Addresses

Primary practice location

11801 South Fwy Ste 140
Burleson, TX 76028-7021

Mailing address

PO Box 16657
Fort Worth, TX 76162-0657
Phone (817) 551-6161

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
I20040806000667 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 6103897673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Texas Medical School at Houston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Center PAGroup PAC ID 1052673829, 3 clinicians
Huguley Medical Associates, IncGroup PAC ID 2668562471, 50 clinicians

Practice addresses (Care Compare)

11801 S Fwy
Suite 140
Burleson, TX 76028-7021
Phone (817) 551-6161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.59 of 100Reported as individual
Quality
99.36
Improvement activities
40
Cost
73.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy309
Upper gastrointestinal (GI) endoscopy for acid reflux221

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Center PA Gastroenterology CurrentSince Jan 16, 2018 Accepting new patients
Gastroenterology Center, PA Gastroenterology PastSince Aug 3, 2004 Accepting new patients

Locations

12001 South Fwy
Ste 305
Burleson, TX 76028
Phone (682) 268-6670

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

11797 South Fwy
Ste 136
Burleson, TX 76028
Phone (817) 551-6161

11801 South Fwy
Ste 140
Burleson, TX 76028
Phone (817) 551-6161

Organizations & group practices 3

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 3

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1306816392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16657",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761620657",
            "telephone_number": "817-551-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY STE 140",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-551-6161",
            "fax_number": "817-551-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISMAR",
        "first_name": "MIKE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L0986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.