Individual provider Active NPI

Sirajunnisa Syeda, P.A.

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1679710404
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09320 Issued in TX
Practice address
1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-3104
Phone
(817) 250-4906
NPI assigned
Jan 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09320 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave Ste K230
Fort Worth, TX 76104-3104

Mailing address

6130 W Parker Rd Ste 306
Plano, TX 75093-7934
Phone (972) 981-7135

Other practice location 1

6130 W Parker Rd Ste 306
Plano, TX 75093
Phone (972) 981-7135

Other identifiers 1

IdentifierTypeStateIssuer
PA20098OtherCASTATE BOARD OF CALIFORNIA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150105001288 TX Practitioner - Physician Assistant 7214063874 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lonestar Hospital Medicine Associates PAGroup PAC ID 6709049703, 126 clinicians
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

11424 Richmond Ave
Houston, TX 77082-2519
Phone (281) 759-7900

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

3500 W Wheatland Rd
Dallas, TX 75237-3460
Phone (214) 947-7777

8440 Walnut Hill LN
Suite 800
Dallas, TX 75231-3825
Phone (214) 345-5999

Hospital & facility affiliations

  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Lake Granbury Medical Center Hospital, Granbury, TX, CCN 450596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09320TXMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ssyeda1363105@direct.texashealth.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 and National Provider Directory roles.

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1679710404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 W PARKER RD STE 306",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937934",
            "telephone_number": "972-981-7135",
            "fax_number": "972-981-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE K230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043104",
            "telephone_number": "817-250-4906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6130 W Parker Rd Ste 306",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "75093",
            "country_code": "US",
            "telephone_number": "972-981-7135",
            "fax_number": "972-981-7136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYEDA",
        "first_name": "SIRAJUNNISA",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF CALIFORNIA",
            "identifier": "PA20098",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.