Individual provider Active NPI

Miraie Wardi, D.O

  • Nephrology Physician
  • Bedford, TX
National Provider Identifier
1386056695
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
S2196 Issued in TX
Practice address
2425 Highway 121 Ste 201
Bedford, TX 76021-5011
Phone
(817) 283-5166
Fax
(817) 283-5176
NPI assigned
May 21, 2014
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X S2196 TX Primary

Addresses

Primary practice location

2425 Highway 121 Ste 201
Bedford, TX 76021-5011

Mailing address

3801 William D Tate Ave Ste 105
Grapevine, TX 76051-8755
Phone (817) 488-6812

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
I20190626001468 TX Practitioner - NephrologyPractitioner - Internal Medicine 0840524799

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3801 William D Tate Ave
Suite 105
Grapevine, TX 76051-8755

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NTKC-DFW, PLLC Nephrology Current Accepting new patients

Locations

4907 S Collins St
Ste 101
Arlington, TX 76018
Phone (817) 375-0610

2425 Highway 121
Ste 201
Bedford, TX 76021
Phone (817) 283-5166

3801 William D Tate Ave
Ste 105
Grapevine, TX 76051
Phone (817) 488-6812

Organizations & group practices 1

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 9

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1386056695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 105",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518755",
            "telephone_number": "817-488-6812",
            "fax_number": "817-251-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HIGHWAY 121 STE 201",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215011",
            "telephone_number": "817-283-5166",
            "fax_number": "817-283-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDI",
        "first_name": "MIRAIE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "S2196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

Verify at the official NPI Registry.