Individual provider Active NPI

Michael Badlissi, M.D.

  • Internal Medicine Physician
  • Nederland, TX
National Provider Identifier
1770710337
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P3115 Issued in TX
Practice address
2300 Highway 365 Ste 330
Nederland, TX 77627-6255
Phone
(409) 727-7342
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P3115 TX Primary

Addresses

Primary practice location

2300 Highway 365 Ste 330
Nederland, TX 77627-6255

Mailing address

2300 Highway 365 Ste 330
Nederland, TX 77627-6255
Phone (409) 727-7342

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120910000875 TX Practitioner - Internal Medicine 2860640216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 Hwy 365
Suite 330
Nederland, TX 77627-6255
Phone (409) 727-7342

Hospital & facility affiliations

  • Home Care Elite LLC Home health agency, Nederland, TX, CCN 677964
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346
  • The Medical Center of Southeast Texas Hospital, Port Arthur, TX, CCN 450518
  • Mid-Jefferson Extended Care Hospital Inpatient rehabilitation facility, Nederland, TX, CCN 45TA83
  • Mid-Jefferson Extended Care Hospital Long-term care hospital, Beaumont, TX, CCN 452083

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P3115TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Badlissi MD PA Internal Medicine CurrentSince Aug 28, 2012 Accepting new patients
Southeast Texas Inpatient Physician Associates CurrentSince Nov 1, 2013 Accepting new patients
Christus Health Southeast Texas Past Accepting new patients
Baptist Hospitals of Southeast Texas Past Accepting new patients
Hsa Port Arthur, LLC Past Accepting new patients

Locations

3318 Highway 365
Nederland, TX 77627
Phone (409) 454-5007

2300 Highway 365
Ste 330
Nederland, TX 77627
Phone (409) 727-7342

2501 Jimmy Johnson Blvd
Ste 302
Port Arthur, TX 77640
Phone (409) 344-9087

2555 Jimmy Johnson Blvd
Port Arthur, TX 77640
Phone (409) 724-7389

Organizations & group practices 5

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 6

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1770710337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365 STE 330",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276255",
            "telephone_number": "409-727-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 365 STE 330",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276255",
            "telephone_number": "409-727-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADLISSI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nederland, TX

Sources for this page

Verify at the official NPI Registry.