Individual provider Active NPI

Ayesha Bashir, M.D.

  • Internal Medicine Physician
  • Osage Beach, MO
National Provider Identifier
1780828657
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012026875 Issued in MO
Practice address
54 Hospital Dr
Ste 204
Osage Beach, MO 65065-3050
Phone
(573) 302-3960
Fax
(573) 348-8217
NPI assigned
Apr 23, 2009
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 2012026875 MO Primary

Addresses

Primary practice location

54 Hospital Dr
Ste 204
Osage Beach, MO 65065-3050

Mailing address

PO Box 1500
Osage Beach, MO 65065-1500

Other identifiers 1

IdentifierTypeStateIssuer
1780828657MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abashir757197@direct.sw.org

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
I20171114003484 TX Practitioner - Internal MedicinePractitioner - Hospitalist 4082865407 Reassigns benefits to 2 organizations
Practice locations: Arlington, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1650 W College St
150 Baylor Scott and White Hospital Medicine
Grapevine, TX 76051-3565
Phone (817) 388-3440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012026875MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 4, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 4, 2021 Accepting new patients
Apogee Medical Group Texas PA Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Baylor Regional Medical Center at Grapevine Past Accepting new patients

Locations

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

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

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

1650 W College St
Ste 150
Grapevine, TX 76051
Phone (817) 338-3440

Interoperability endpoints

  • Direct secure messaging: ayesha.bashir.1@13957.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1780828657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650651500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "address_2": "STE 204",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-302-3960",
            "fax_number": "573-348-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIR",
        "first_name": "AYESHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012026875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780828657",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abashir757197@direct.sw.org",
            "affiliation": "N",
            "address_1": "1650 W College St Ste 150",
            "city": "Grapevine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760513565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.