NPIMap

Individual provider Active NPI

Shafeeq Noorudeen

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1477810091
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q2934 Issued in TX
Practice address
4700 Alliance Blvd
Suite 400
Plano, TX 75093-5323
Phone
(469) 814-2000
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 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 Q2934 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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address snoorudeen262379@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831000258 TX Practitioner - Internal Medicine 8426291626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider Network 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

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
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Apr 3, 2016 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network--Dallas Diagnostic Association Internal Medicine CurrentSince Aug 24, 2015 Accepting new patients
Healthtexas-Dallas Diagnostic Association Internal Medicine CurrentSince Aug 24, 2015 Accepting new patients
Healthtexas Provider Network CurrentSince Apr 3, 2016 Accepting new patients
Baylor Regional Medical Center at Plano Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

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

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

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 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 3

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1477810091",
    "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"
        },
        {
            "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": "469-814-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORUDEEN",
        "first_name": "SHAFEEQ",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "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": "TX",
            "license": "Q2934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snoorudeen262379@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.