Organization Active NPI

Lubbock Nephrology Associates, P.a.

  • Nephrology Physician
  • Lubbock, TX
National Provider Identifier
1760681001
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
L7888 Issued in TX
Legal business name
LUBBOCK NEPHROLOGY ASSOCIATES, P.A.
Practice address
3708 22ND PL
Suite a
Lubbock, TX 79410-1351
Phone
(806) 771-7412
Fax
(806) 771-7414
NPI assigned
Jul 17, 2007
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Maybin Simfukwe, M.D.NPI 1689635559
Title
President
Phone
(806) 771-1386

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L7888 TX
Nephrology Physician 207RN0300X
Nephrology Physician 207RN0300X L7888 TX Primary

Addresses

Primary practice location

3708 22ND PL
Suite a
Lubbock, TX 79410-1351

Mailing address

PO Box 54136
Lubbock, TX 79453-4136
Phone (806) 771-1386

Other practice location 1

2232 Indiana Ave Ste 1
Lubbock, TX 79410-2147
Phone (806) 771-1386

Other practice location 2

3180 Executive Dr Ste 102
San Angelo, TX 76904-6837
Phone (806) 771-7412

Other identifiers 1

IdentifierTypeStateIssuer
191390701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080102000341 TX Part B Supplier - Clinic/Group Practice 6406936525 Receives reassigned benefits from 5 practitioners
Practice locations: Lubbock, TX; San Angelo, TX

National Provider Directory

National Provider Directory

Locations

2232 Indiana Ave
Lubbock, TX 79410
Phone (469) 389-8959

3708 22nd Pl
Ste A
Lubbock, TX 79410
Phone (806) 771-7412

3708 22nd Pl
Unit 1
Lubbock, TX 79410
Phone (806) 771-7412

3180 Executive Dr
Ste 102
San Angelo, TX 76904
Phone (325) 944-1240

Interoperability endpoints

  • Direct secure messaging: elmoutazmousa@lubbockneph.allscriptsdirect.net
  • Direct secure messaging: maybinsimfukwe@lubbockneph.allscriptsdirect.net
  • Direct secure messaging: sorotphisitkul@lubbockneph.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1760681001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54136",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794534136",
            "telephone_number": "806-771-1386",
            "fax_number": "806-771-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 22ND PL",
            "address_2": "SUITE A",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101351",
            "telephone_number": "806-771-7412",
            "fax_number": "806-771-7414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Indiana Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794102147",
            "country_code": "US",
            "telephone_number": "806-771-1386",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3180 Executive Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Angelo",
            "state": "TX",
            "postal_code": "769046837",
            "country_code": "US",
            "telephone_number": "806-771-7412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUBBOCK NEPHROLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "SIMFUKWE",
        "authorized_official_first_name": "MAYBIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-771-1386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L7888",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "L7888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191390701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.

Verify at the official NPI Registry.