Individual provider Active NPI

Uma Edayllam Nambiar, MBBS

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1619183522
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R5605 Issued in TX
Practice address
1400 S Main St Ste 400Ab
Fort Worth, TX 76104-4909
Phone
(817) 927-1307
NPI assigned
May 15, 2007
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD449761 PA
Pediatrics Physician 208000000X 046825 CT
Pediatrics Physician 208000000X R5605 TX Primary

Addresses

Primary practice location

1400 S Main St Ste 400Ab
Fort Worth, TX 76104-4909

Mailing address

6937 Laurel Valley Dr
Fort Worth, TX 76132-4461
Phone (860) 422-0151

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
I20190626000386 TX Practitioner - Pediatric Medicine 4486842234 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046825CTMDPediatrics Physician
MD449761PAMDPediatrics Physician
R5605TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince May 20, 2019 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Past Accepting new patients
Healthwise Medical Associates, LLP Pediatrics Past Accepting new patients
Tarrant County Hospital District Past Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1400 S Main St
Ste 400AB
Fort Worth, TX 76104
Phone (817) 927-1307

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

Interoperability endpoints

  • Direct secure messaging: unambiar72280@direct.jpshealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1619183522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6937 LAUREL VALLEY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324461",
            "telephone_number": "860-422-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST STE 400AB",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044909",
            "telephone_number": "817-927-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBIAR",
        "first_name": "UMA",
        "middle_name": "EDAYLLAM",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD449761",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "046825",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R5605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.