Active NPI
Baytown Family Practice PA
- Family Medicine Physician
- Baytown, TX
National Provider Identifier
1619683539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- BAYTOWN FAMILY PRACTICE PA
- Practice address
- 1618 W Baker Rd Ste B
Baytown, TX 77521-2280 - Phone
- (281) 837-0846
- Fax
- (281) 837-6186
- NPI assigned
- Jan 24, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shahina Q Ali, MD
- Title
- Owner
- Phone
- (281) 837-0846
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1618 W Baker Rd Ste B
Baytown, TX 77521-2280
Mailing address
1618 W Baker Rd Ste B
Baytown, TX 77521-2280
Phone (281) 837-0846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111878801 | Medicaid | TX |
Other names 1
- BAYTOWN FAMILY PRACTICE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230223000008 | TX | Part B Supplier - Clinic/Group Practice | 5294108262 |
Receives reassigned benefits from 1 practitioner Practice locations: Baytown, TX |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674518400000",
"number": "1619683539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1618 W BAKER RD STE B",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775212280",
"telephone_number": "281-837-0846",
"fax_number": "281-837-6186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1618 W BAKER RD STE B",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775212280",
"telephone_number": "281-837-0846",
"fax_number": "281-837-6186"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYTOWN FAMILY PRACTICE PA",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A",
"authorized_official_last_name": "ALI",
"authorized_official_first_name": "SHAHINA",
"authorized_official_middle_name": "Q",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "281-837-0846",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111878801",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BAYTOWN FAMILY PRACTICE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Baytown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.