Mehboob S Qassam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

J4972 Issued in TX

Practice address

11801 S. Freeway
Fort Worth, TX 76134

Phone

(817) 293-9110

NPI assigned

Apr 18, 2006

Last updated

Oct 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

Practice roles

Locations

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.

• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment NPD
• Huguley Emergency Physicians, LLP

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fort Worth, TX
  • NPI 1346265071
  Medicare reassignment NPD

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1508821216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 LAUREL VALLEY CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 S. FREEWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76134",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QASSAM",
        "first_name": "MEHBOOB",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J4972",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J4972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137389608",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista M Putty, MD
• Emily Pybus, PT, DPT
• Kristen Pyrc, M.D.
• Pyxis Investment Group, LLC (PyxisCare Management)
• Shabnam K Qasim, MD
• QF Enterprises Inc (Right at Home Inc)
• Qian Amy Qian Dental PLLC
• Junqiu Qian, NP-C
• Qian Amy Qian, DDS
• Alexander Minh Quach

• Internal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.