Individual provider Active NPI

Shamsuddin Sherali Pepermintwala, MD

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1316035546
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
K4525 Issued in TX
Practice address
1340 River Bend Dr
Dallas, TX 75247-4914
Phone
(214) 743-6188
Fax
(214) 905-9245
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X K4525 TX Primary
Child & Adolescent Psychiatry Physician 2084P0804X K4525 TX

Addresses

Primary practice location

1340 River Bend Dr
Dallas, TX 75247-4914

Mailing address

1340 River Bend Dr
Dallas, TX 75247-4914
Phone (214) 743-6188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4525TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Pepermintwala PLLC Child & Adolescent Psychiatry Current Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas Metrocare Services PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Adapt of Texas, Inc. Past Accepting new patients
Dallas Metrocare Service PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas Metrocare Services PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas Metrocare Services Past Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas Metrocare Services PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients
Dallas County MHMR PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1316035546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-6188",
            "fax_number": "214-905-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-6188",
            "fax_number": "214-905-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPERMINTWALA",
        "first_name": "SHAMSUDDIN",
        "middle_name": "SHERALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "K4525",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "K4525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.