Individual provider Active NPI

Shireen A Bashiri

  • Physical Therapist
  • Helotes, TX
National Provider Identifier
1396226841
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1307152 Issued in TX
Practice address
12952 Bandera Rd Ste 107
Helotes, TX 78023-4733
Phone
(210) 372-9600
Fax
(210) 392-9923
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1307152 TX Primary

Addresses

Primary practice location

12952 Bandera Rd Ste 107
Helotes, TX 78023-4733

Mailing address

12952 Bandera Rd Ste 107
Helotes, TX 78023-4733
Phone (210) 372-9600

Other identifiers 1

IdentifierTypeStateIssuer
1307152OtherTXPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925000186 TX Practitioner - Physical Therapist in Private Practice 9830440221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation Physical Therapy PLLCGroup PAC ID 0648428987, 10 clinicians

Practice addresses (Care Compare)

23127 Ih 10
Suite 203
San Antonio, TX 78257-2506
Phone (210) 698-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1307152TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Physical Therapy, PLLC Physical Therapist CurrentSince Aug 19, 2019 Accepting new patients
Momentum Physical & Sports Rehabilitation Limited Partnership Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients
Momentum Physical & Sports Rehabilitation Limited Partnership Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients

Locations

905 N Main St
Ste 103
Boerne, TX 78006
Phone (830) 816-5333

12952 Bandera Rd
Ste 107
Helotes, TX 78023
Phone (210) 372-9600

23127 W Interstate 10
Ste 203
San Antonio, TX 78257
Phone (210) 698-6332

5441 Babcock Rd
Ste 103
San Antonio, TX 78240
Phone (210) 253-3888

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.

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1396226841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12952 BANDERA RD STE 107",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234733",
            "telephone_number": "210-372-9600",
            "fax_number": "210-392-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12952 BANDERA RD STE 107",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234733",
            "telephone_number": "210-372-9600",
            "fax_number": "210-392-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIRI",
        "first_name": "SHIREEN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1307152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1307152",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helotes, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.