Individual provider Active NPI

Shireen Sarah Rostami, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1730750605
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14726 Issued in TX
Practice address
9805 Fitzroy Dr
Dallas, TX 75238-4317
Phone
(214) 417-1077
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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 PA14726 TX Primary

Addresses

Primary practice location

9805 Fitzroy Dr
Dallas, TX 75238-4317

Mailing address

9805 Fitzroy Dr
Dallas, TX 75238-4317
Phone (214) 417-1077

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL None

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
I20210916002692 TX Practitioner - Physician Assistant 4385041458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

4501 Swiss Ave
Baylor Scott and White
Dallas, TX 75204-7119
Phone (214) 820-8700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 27, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 27, 2021 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

Interoperability endpoints

  • Direct secure messaging: srostami302113@direct.sw.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1730750605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 FITZROY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384317",
            "telephone_number": "214-417-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9805 FITZROY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384317",
            "telephone_number": "214-417-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTAMI",
        "first_name": "SHIREEN",
        "middle_name": "SARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "address_1": "9805 Fitzroy Dr",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752384317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.