Individual provider Active NPI

Imtiaz Sadiq, MD

  • Internal Medicine Physician
  • Odessa, TX
National Provider Identifier
1407319288
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101274561 Issued in VA
Practice address
701 W 5TH St
Odessa, TX 79763-4206
Phone
(432) 703-5375
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0101274561 VA Primary

Addresses

Primary practice location

701 W 5TH St
Odessa, TX 79763-4206

Mailing address

701 W 5TH St
Odessa, TX 79763-4206
Phone (432) 703-5375

Other identifiers 1

IdentifierTypeStateIssuer
1325467980MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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
I20220411002083 VA Practitioner - Internal Medicine 4587991047 Reassigns benefits to 3 organizations
I20220917000102 DC Practitioner - Internal Medicine 4587991047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Virginia LLCGroup PAC ID 5698842235, 76 clinicians

Practice addresses (Care Compare)

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

759 S Main St
Woodstock, VA 22664-1127
Phone (540) 459-1285

Hospital & facility affiliations

  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101274561VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Sep 6, 2022 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 6, 2022 Accepting new patients
Hospitalist Medicine Physicians of Virginia LLC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Sep 6, 2022 Accepting new patients
Hospitalist Medicine Physicians of Fredericksburg, LLC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Winchester Medical Center Past Accepting new patients
Arnot Medical Services PLLC Internal Medicine Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Organizations & group practices 7

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 2

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1407319288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-703-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-703-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADIQ",
        "first_name": "IMTIAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1325467980",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.