NPIMap

Individual provider Active NPI

Reza Abbas Ali, MD

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1669625448
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
R4355 Issued in TX
Practice address
12011 State Highway 151 Ste 202
San Antonio, TX 78251-1230
Phone
(210) 265-8155
Fax
(210) 477-4750
NPI assigned
Oct 24, 2008
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26338 OK
Nephrology Physician 207RN0300X R4355 TX Primary

Addresses

Primary practice location

12011 State Highway 151 Ste 202
San Antonio, TX 78251-1230

Mailing address

215 N San Saba Ste 301
San Antonio, TX 78207-3164
Phone (210) 212-8622

Other practice location 1

215 N San Saba Ste 301
San Antonio, TX 78207-3164
Phone (210) 212-8984

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address reza.ali@strcg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131000748 TX Practitioner - NephrologyPractitioner - Internal Medicine 5193966224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
M Reza Mizani MD PAGroup PAC ID 5294709689, 28 clinicians

Practice addresses (Care Compare)

215 N San Saba
Suite 301
San Antonio, TX 78207-3164
Phone (210) 212-8622

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26338OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Reza Mizani, M.D., P.a. Nephrology CurrentSince Mar 1, 2018 Accepting new patients
M. Reza Mizani, M.D., P.a. CurrentSince Mar 1, 2018 Accepting new patients
M. Reza Mizani, M.D., P.a. Nephrology Past Accepting new patients
Nephrology Associates of Central Kentucky LLC Nephrology PastSince Aug 1, 2013 Accepting new patients

Locations

205 22nd St
Hondo, TX 78861
Phone (830) 426-2753

12011 State Highway 151
Ste 202
San Antonio, TX 78251
Phone (210) 265-8155

215 N San Saba
Ste 301
San Antonio, TX 78207
Phone (210) 212-8984

343 W Houston St
Ste 609
San Antonio, TX 78205
Phone (210) 212-4595

Interoperability endpoints

  • Direct secure messaging: reza.ali@strcg.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 12

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1669625448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N SAN SABA STE 301",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073164",
            "telephone_number": "210-212-8622",
            "fax_number": "210-212-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 STATE HIGHWAY 151 STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511230",
            "telephone_number": "210-265-8155",
            "fax_number": "210-477-4750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 N San Saba Ste 301",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073164",
            "country_code": "US",
            "telephone_number": "210-212-8984",
            "fax_number": "210-212-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "REZA",
        "middle_name": "ABBAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-24",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "26338",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "R4355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reza.ali@strcg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "South Texas Renal Care Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "12011 State Highway 151 Ste 202",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782511230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.