Active NPI
Hamid R Roodneshin, M.D.
- Cardiovascular Disease Physician
- Lufkin, TX
National Provider Identifier
1710197298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 52946-20
- Practice address
- 310 Gaslight Blvd
Lufkin, TX 75904-3133 - Phone
- (936) 632-8787
- Fax
- (936) 632-8832
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R7611 | IA | |
| Cardiovascular Disease Physician | 207RC0000X | 52946-20 | WI | Primary |
Addresses
Primary practice location
310 Gaslight Blvd
Lufkin, TX 75904-3133
Mailing address
910 W 5TH Ave
Spokane, WA 99204-2966
Phone (509) 838-2531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7611 | IA | MD | Internal Medicine Physician |
| 52946-20 | WI | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1710197298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 W 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042966",
"telephone_number": "509-838-2531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 GASLIGHT BLVD",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043133",
"telephone_number": "936-632-8787",
"fax_number": "936-632-8832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROODNESHIN",
"first_name": "HAMID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "R7611",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WI",
"license": "52946-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.