Individual provider Active NPI

Pervaiz Rahman, M.D.

  • Gastroenterology Physician
  • Dallas, TX
National Provider Identifier
1598772402
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
F7892 Issued in TX
Practice address
1 Medical Pkwy Ste 103
Dallas, TX 75234-7830
Phone
(972) 681-9800
Fax
(972) 681-9804
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X F7892 TX Primary

Addresses

Primary practice location

1 Medical Pkwy Ste 103
Dallas, TX 75234-7830

Mailing address

8078 Acoma LN
Dallas, TX 75252-8031
Phone (972) 681-9800

Other identifiers 1

IdentifierTypeStateIssuer
0348666MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, AR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20050810000528 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 8729021886
I20231020000247 NM Practitioner - Gastroenterology 8729021886 Reassigns benefits to 1 organization
I20240401003312 AR Practitioner - Gastroenterology 8729021886 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Oct 1, 2023 Accepting new patients
Baptist Health Services Current Accepting new patients
Baptist Health Services CurrentSince Apr 1, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 1, 2023 Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients
One World Medical Associates PA Past Accepting new patients
Southwest Rheumatology PA Past Accepting new patients
Mesquite Arthritis Clinic, P.a. Past Accepting new patients

Locations

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7260

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Ste 19100
Rio Rancho, NM 87124
Phone (505) 224-7000

Interoperability endpoints

  • Direct secure messaging: pervaiz.rahman.1@18481.direct.athenahealth.com
  • Direct secure messaging: dmcprahma@yourcarecommunity.org
  • Direct secure messaging: prahman240393@direct.phs.org

Organizations & group practices 8

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1598772402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8078 ACOMA LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752528031",
            "telephone_number": "972-681-9800",
            "fax_number": "972-681-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PKWY STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347830",
            "telephone_number": "972-681-9800",
            "fax_number": "972-681-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "PERVAIZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F7892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.