Individual provider Active NPI

Shahab Ahmad, M.D

  • Adolescent Medicine (Internal Medicine) Physician
  • Richardson, TX
National Provider Identifier
1558329979
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
K9713 Issued in TX
Practice address
2100 N.Collins Blvd
Suite 315
Richardson, TX 75080
Phone
(972) 235-2304
Fax
(972) 235-8442
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X K9713 TX Primary

Addresses

Primary practice location

2100 N.Collins Blvd
Suite 315
Richardson, TX 75080

Mailing address

2100 N Collins Blvd
Suite 315
Richardson, TX 75080-2661
Phone (972) 235-2304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SD2 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
I20101129000643 TX Practitioner - Internal MedicinePractitioner - General Practice 5991879173 Reassigns benefits to 1 organization
I20180502002398 SD Practitioner - Internal Medicine 5991879173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

399 W Campbell Rd
Suite 304
Richardson, TX 75080-3620
Phone (972) 235-2304

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Apr 4, 2018 Accepting new patients
North Dallas Primary Care P.a CurrentSince Aug 6, 2001 Accepting new patients
Avera McKennan CurrentSince Apr 4, 2018 Accepting new patients

Locations

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

2100 N Collins Blvd
Ste 315
Richardson, TX 75080
Phone (972) 235-2304

399 W Campbell Rd
Ste 304
Richardson, TX 75080
Phone (972) 235-2304

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BABEAD/Endpoint/BABEAD
  • Direct secure messaging: shahab.ahmad@ndpc.eclinicaldirectplus.com

Organizations & group practices 4

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 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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1558329979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N COLLINS BLVD",
            "address_2": "SUITE 315",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802661",
            "telephone_number": "972-235-2304",
            "fax_number": "972-235-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N.COLLINS BLVD",
            "address_2": "SUITE 315",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75080",
            "telephone_number": "972-235-2304",
            "fax_number": "972-235-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "SHAHAB",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TX",
            "license": "K9713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.