Diba Shabani, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16260 Issued in TX

Practice address

1227 Museum Square Dr Ste a
Sugar Land, TX 77479-4630

Phone

(281) 915-9041

NPI assigned

Sep 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Diba Saghizadeh Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Memorial Hermann Urgent Care PLLC

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1730821208
  Medicare reassignment

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1417629221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 WILLIAMS TRACE BLVD STE 110",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784440",
            "telephone_number": "281-491-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 MUSEUM SQUARE DR STE A",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794630",
            "telephone_number": "281-915-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 Williams Trace Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774784440",
            "country_code": "US",
            "telephone_number": "281-491-1911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2425 County Road 90",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775844883",
            "country_code": "US",
            "telephone_number": "281-997-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABANI",
        "first_name": "DIBA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "2021011607",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIBA",
            "last_name": "SAGHIZADEH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Damilola Seriki, NURSE PRACTITIONER
• Sanjay Sethi, MD
• Lora Setterlund, APRN
• Magdalena Maria Sevilla, DC
• Sevyn Haven Homecare LLC
• Jonathon B Shaffer, MD
• Imran Shafi, P.A.
• Bakhtiar Shah, M.D.
• Bhadresh B Shah, M.D.
• Bhavna (Bobbie) K Shah, OTR

• Physician Assistant in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.