Individual provider Active NPI

Roger Bedimo, M.D.

  • Infectious Disease Physician
  • Dallas, TX
National Provider Identifier
1508879859
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
00024235 Issued in AL
Practice address
4500 S Lancaster Rd
Suite 111-D
Dallas, TX 75216-7167
Phone
(214) 857-0397
Fax
(214) 302-1433
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 00024235 AL Primary

Addresses

Primary practice location

4500 S Lancaster Rd
Suite 111-D
Dallas, TX 75216-7167

Mailing address

2020 Old Orchard Dr
Dallas, TX 75208-3129
Phone (214) 943-7174

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
I20110930000242 TX Order and Referring Only - Infectious DiseasePractitioner - Internal MedicinePractitioner - Infectious Disease 5496927105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00024235ALMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508879859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 OLD ORCHARD DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752083129",
            "telephone_number": "214-943-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "SUITE 111-D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-0397",
            "fax_number": "214-302-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDIMO",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AL",
            "license": "00024235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.