Khalisa Israt Jahan Syeda, D.O.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

DO.2052 Issued in AL

Practice address

540 Westgate Pkwy
Dothan, AL 36303

Phone

(205) 934-3460

NPI assigned

Sep 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

University of North Texas HSC, College of Osteopathic Med, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation PC

  • Clinic/Center
  • Birmingham, AL
  • NPI 1528078219

  Pediatric Cardiology

  NPD

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1326474438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 WESTGATE PKWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033073",
            "telephone_number": "205-934-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 WESTGATE PKWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36303",
            "telephone_number": "205-934-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 Fannin Street",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770305389",
            "country_code": "US",
            "telephone_number": "832-325-6516",
            "fax_number": "713-512-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYEDA",
        "first_name": "KHALISA",
        "middle_name": "ISRAT JAHAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AL",
            "license": "DO.2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Swim, CRNA
• Thomas Swim, MA, ALC, NCC
• Anna Swinehart
• Keshawna Swinton
• Humza Syed, MD
• Steven H Sykes, MD
• Ricardo Syklawer, MD
• Synapses Lab LLC
• T M Supply Inc
• Jeffrey M. Tamburin, M.D.

• Pediatric Cardiology Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Pediatric Cardiology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.