Active NPI
Muhammad Anis Memon, M.D.
- Gastroenterology Physician
- Mansfield, TX
National Provider Identifier
1780691923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 154192
- Practice address
- 2800 E Broad St
Suite 204
Mansfield, TX 76063-6409 - Phone
- (817) 477-5500
- Fax
- (817) 453-5503
- NPI assigned
- Aug 1, 2006
- Last updated
- Sep 24, 2014
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | M1931 | TX | |
| Gastroenterology Physician | 207RG0100X | 154192 | TX | Primary |
Addresses
Primary practice location
2800 E Broad St
Suite 204
Mansfield, TX 76063-6409
Mailing address
2800 E Broad St
Suite 204
Mansfield, TX 76063-6409
Phone (817) 477-5500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180095501 | Medicaid | TX | |
| P00262265 | Other | TX | MEDICARE RR |
| 5915477 | Other | TX | AETNA |
| 0001NA | Other | TX | BCBS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2800 E Broad St
Suite 500
Mansfield, TX 76063-6416
Phone (817) 477-5500
Hospital & facility affiliations
- Methodist Mansfield Medical Center
- Methodist Midlothian Medical Center
- Texas Health Hospital Mansfield
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 126 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 257 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 154192 | TX | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medhealth | Current | Accepting new patients | |
| Medhealth | Current | Accepting new patients | |
| Saeed Ahmed MD PSC | Specialist | Past | Accepting new patients |
Locations
5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691
2800 E Broad St
Ste 500
Mansfield, TX 76063
Phone (682) 900-4174
613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700
Interoperability endpoints
- mmemon14165@dm.mhd.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Elizabethtown, KY
- NPI 1336306299
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Methodist Midlothian Medical Center
- General Acute Care Hospital
- Midlothian, TX
- NPI 1487271375
-
dba Methodist Mansfield Medical Center
- General Acute Care Hospital
- Mansfield, TX
- NPI 1689629941
-
- General Acute Care Hospital
- Mansfield, TX
- NPI 1356960132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411516800000",
"number": "1780691923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 E BROAD ST",
"address_2": "SUITE 204",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760636409",
"telephone_number": "817-477-5500",
"fax_number": "817-453-5503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 E BROAD ST",
"address_2": "SUITE 204",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760636409",
"telephone_number": "817-477-5500",
"fax_number": "817-453-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEMON",
"first_name": "MUHAMMAD",
"middle_name": "ANIS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2014-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "M1931",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "154192",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180095501",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00262265",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5915477",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0001NA",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.