Individual provider Active NPI

Mahmoud N Soubra, M.D.

  • Gastroenterology Physician
  • Austin, TX
National Provider Identifier
1427212224
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
S4060 Issued in TX
Practice address
12221 N Mopac Expy
Austin, TX 78758-2401
Phone
(512) 901-4007
Fax
(512) 901-3907
NPI assigned
Jul 11, 2008
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39553 IA
Gastroenterology Physician 207RG0100X MD-39553 IA
Gastroenterology Physician 207RG0100X S4060 TX Primary

Addresses

Primary practice location

12221 N Mopac Expy
Austin, TX 78758-2401

Mailing address

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-4937

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MAHMOUD.SOUBRA@hca8.eclinicaldirectplus.com

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
I20200305000999 TX Practitioner - Gastroenterology 6901075654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-2530

5701 W Slaughter LN
BLDG C
Austin, TX 78749-6528
Phone (512) 334-2401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
64.52
Promoting interoperability
100
Improvement activities
40
Cost
73.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39553IAMDInternal Medicine Physician
S4060TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Austin Diagnostic Clinic, PLLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
The Austin Diagnostic Clinic, PLLC Current Accepting new patients
Austin Diagnostic Clinic CurrentSince Mar 1, 2020 Accepting new patients
The Austin Diagnostic Clinic, PLLC Past Accepting new patients
Austin Diagnostic Clinic, PA Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

1330 Wonder World Dr
Ste 101
San Marcos, TX 78666
Phone (512) 805-0680

1250 S Capital of Texas Hwy
West Lake Hills, TX 78746
Phone (512) 334-2403

Interoperability endpoints

  • Direct secure messaging: 11220-soubra-mahmoud@direct.leadingreach.com

Organizations & group practices 5

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.

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1427212224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4937",
            "fax_number": "512-901-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4007",
            "fax_number": "512-901-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUBRA",
        "first_name": "MAHMOUD",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2022-02-09",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "39553",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "MD-39553",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "S4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MAHMOUD.SOUBRA@hca8.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12221 N Mopac Expy",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787582401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.