Individual provider Active NPI

Ahmad Hashem Altarawneh

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1487933446
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
T3238 Issued in TX
Practice address
4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone
(210) 690-7400
Fax
(210) 690-7405
NPI assigned
Aug 9, 2011
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD19287 ME
Critical Care Medicine (Internal Medicine) Physician 207RC0200X T3238 TX
Student in an Organized Health Care Education/Training Program 390200000X 00000000000000000000 NJ
Nephrology Physician 207RN0300X T3238 TX Primary

Addresses

Primary practice location

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748

Mailing address

100 Franklin St Apt 207D
Morristown, NJ 07960-5440
Phone (612) 607-3289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, TX2 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
I20121231000122 ME Practitioner - Internal Medicine 3173776002 Reassigns benefits to 1 organization
I20211208001591 TX Practitioner - Critical Care (Intensivists)Practitioner - Nephrology 3173776002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Nephrology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ips LLCGroup PAC ID 9638356801, 44 clinicians

Practice addresses (Care Compare)

1434 E Sonterra Blvd
Suite 210
San Antonio, TX 78258-4973
Phone (210) 690-7400

4458 Medical Dr
Suite 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

4499 Medical Dr
Suite 150
San Antonio, TX 78229-3735
Phone (210) 690-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000000000000000000NJMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC Critical Care Medicine CurrentSince Nov 1, 2021 Accepting new patients

Locations

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
San Antonio, TX 78229
Phone (210) 575-4325

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

4499 Medical Dr
Ste 150
San Antonio, TX 78229
Phone (210) 614-8181

Organizations & group practices 2

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 6

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": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1487933446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FRANKLIN ST APT 207D",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079605440",
            "telephone_number": "612-607-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400",
            "fax_number": "210-690-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTARAWNEH",
        "first_name": "AHMAD",
        "middle_name": "HASHEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD19287",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "T3238",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "00000000000000000000",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "T3238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.