Individual provider Active NPI

Nima Pakzad, M.D.

  • Emergency Medicine Physician
  • Tyler, TX
National Provider Identifier
1407260276
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
583389 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-4262
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 583389 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000

Other practice location 1

2401 Soth 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Other practice location 2

2401 Soth 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Other identifiers 6

IdentifierTypeStateIssuer
552843YS6VOtherTXMEDICARE
P02013462OtherTXMEDICARE RAIL ROAD
P02056998OtherTXMEDICARE RAIL ROAD
8JA411OtherTXBCBS
366627304MedicaidTX
552843YS6POtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170131001103 TX Practitioner - Emergency Medicine 1153602420 Reassigns benefits to 6 organizations
I20170901000566 OK Practitioner - Emergency Medicine 1153602420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Texas Emergency Physicians PLLCGroup PAC ID 8527420306, 195 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
583389TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Medical Center Company CurrentSince Jan 30, 2017 Accepting new patients
Union Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 11, 2023 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Apr 1, 2018 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Nov 27, 2016 Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC Emergency Medicine CurrentSince Aug 19, 2017 Accepting new patients
Northeast Texas Emergency Physicians, PLLC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Nov 27, 2016 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Apr 1, 2018 Accepting new patients
Comanche County Medical Center Company CurrentSince Jan 30, 2017 Accepting new patients

Locations

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

10201 Highway 16
Comanche, TX 76442
Phone (254) 879-4910

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: npakzad119912@ahs.direct-ci.com
  • Direct secure messaging: npakzad154851@christushealth.direct-ci.net

Organizations & group practices 9

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1407260276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-4262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Soth 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Soth 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAKZAD",
        "first_name": "NIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "583389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "552843YS6V",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02013462",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02056998",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JA411",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366627304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "552843YS6P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.