NPIMap

Individual provider Active NPI

Tabreez Shiraaz Ali, D.O.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1376799064
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO1552 Issued in NV
Practice address
28 Brookridge Dr
Henderson, NV 89052-6620
Phone
(702) 487-7055
Fax
(702) 991-7258
NPI assigned
Aug 13, 2008
Last updated
Oct 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X DO1552 NV
Internal Medicine Physician 207R00000X DO1552 NV Primary

Addresses

Primary practice location

28 Brookridge Dr
Henderson, NV 89052-6620

Mailing address

PO Box 36830
Las Vegas, NV 89133-6830
Phone (702) 487-7055

Other identifiers 1

IdentifierTypeStateIssuer
1376799064MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322001062 NV Practitioner - Internal Medicine 4385827898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5110 W Sahara Ave
Las Vegas, NV 89146-3406
Phone (702) 858-7376

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1552NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tabreez S Ali DO PC Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Henderson Hospital Past Accepting new patients

Locations

5110 W Sahara Ave
Las Vegas, NV 89146
Phone (702) 352-9260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Enhabit HospiceLas Vegas, NV, CCN 291528 Hospice Contracted Managing Employee Oct 2, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1376799064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36830",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891336830",
            "telephone_number": "702-487-7055",
            "fax_number": "702-991-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 BROOKRIDGE DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890526620",
            "telephone_number": "702-487-7055",
            "fax_number": "702-991-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "TABREEZ",
        "middle_name": "SHIRAAZ",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "DO1552",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376799064",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.