Individual provider Active NPI

Tayyab Pasha

  • Pediatrics Physician
  • Wharton, TX
National Provider Identifier
1528402997
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q8597 Issued in TX
Practice address
2112 Regional Medical Dr Ste 1315
Wharton, TX 77488-1413
Phone
(979) 245-2008
NPI assigned
Apr 29, 2013
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q8597 TX Primary

Addresses

Primary practice location

2112 Regional Medical Dr Ste 1315
Wharton, TX 77488-1413

Mailing address

101 Avenue F N
Bay City, TX 77414-3167
Phone (979) 245-2008

Other identifiers 1

IdentifierTypeStateIssuer
359984702MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.athenanet.athenahealth.com Health Information Exchange (HIE)

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
I20160714001755 TX Practitioner - Pediatric Medicine 9638461494 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Matagorda Episcopal Health Outreach Program CurrentSince Sep 1, 2020 Accepting new patients
Matagorda Episcopal Health Outreach Program Corporation CurrentSince Sep 1, 2020 Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients
J Raul Soto MD PA Past Accepting new patients
Matagorda Episcopal Health Outreach Program PastSince Aug 25, 2019 Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients

Locations

101 Avenue F N
Bay City, TX 77414

111 Avenue F
Bay City, TX 77414
Phone 9792452008300

111 Avenue F N
Bay City, TX 77414
Phone 9792452008302

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

909 Frostwood Dr
Fl 1
Houston, TX 77024

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

307 Green Ave
Ste A
Palacios, TX 77465
Phone 9792452008300

2100 Regional Medical Dr
Wharton, TX 77488
Phone (979) 532-1700

2112 Regional Medical Dr
Ste 1313
Wharton, TX 77488
Phone 9792452008300

2112 Regional Medical Dr
Ste 1315
Wharton, TX 77488
Phone 9792452008300

2112 Regional Medical Dr
Ste 1317
Wharton, TX 77488
Phone 9792452008300

Interoperability endpoints

  • Direct secure messaging: tayyab.pasha.1@17406.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1528402997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE F N",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143167",
            "telephone_number": "979-245-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 REGIONAL MEDICAL DR STE 1315",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774881413",
            "telephone_number": "979-245-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASHA",
        "first_name": "TAYYAB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q8597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "359984702",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.athenanet.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cloud",
            "address_1": "2100 Regional Medical Dr",
            "city": "Wharton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774889719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wharton, TX

Sources for this page

Verify at the official NPI Registry.