Individual provider Active NPI

Abeezar Tamim Shipchandler, M.D.

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1407059595
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N6998 Issued in TX
Practice address
4700 Alliance Blvd
Suite 400
Plano, TX 75093-5323
Phone
(469) 814-6631
Fax
(469) 814-3110
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N6998 TX Primary

Addresses

Primary practice location

4700 Alliance Blvd
Suite 400
Plano, TX 75093-5323

Mailing address

4700 Alliance Blvd
Suite 400
Plano, TX 75093-5323
Phone (469) 814-6631

Other identifiers 2

IdentifierTypeStateIssuer
2174419-01MedicaidTX
2174419--02MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashipchandler262398@direct.sw.org

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
I20101123001237 TX Practitioner - Internal Medicine 9537227384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4700 Alliance Blvd
Plano, TX 75093-5323

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N6998TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas-Dallas Diagnostic Association Internal Medicine CurrentSince Aug 3, 2010 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 1, 2018 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Jul 1, 2018 Accepting new patients
Healthtexas Provider Network--Dallas Diagnostic Association Internal Medicine CurrentSince Aug 3, 2010 Accepting new patients
Baylor Regional Medical Center at Plano Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 558
Dallas, TX 75246

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4700 Alliance Blvd
Ste 400
Plano, TX 75093
Phone (469) 814-6631

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1407059595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 ALLIANCE BLVD",
            "address_2": "SUITE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935323",
            "telephone_number": "469-814-6631",
            "fax_number": "469-814-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 ALLIANCE BLVD",
            "address_2": "SUITE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935323",
            "telephone_number": "469-814-6631",
            "fax_number": "469-814-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPCHANDLER",
        "first_name": "ABEEZAR",
        "middle_name": "TAMIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2174419-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2174419--02",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashipchandler262398@direct.sw.org",
            "affiliation": "N",
            "address_1": "4700 Alliance Blvd",
            "address_2": "Suite 400",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750935323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.