Individual provider Active NPI

Moheb Nabil Boktor

  • Gastroenterology Physician
  • Dallas, TX
National Provider Identifier
1811187354
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R9190 Issued in TX
Practice address
6201 Harry Hines Blvd
Dallas, TX 75390-4228
Phone
(214) 645-6355
NPI assigned
Jul 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.203838 LA
Gastroenterology Physician 207RG0100X MD.203838 LA
Gastroenterology Physician 207RG0100X R9190 TX Primary

Addresses

Primary practice location

6201 Harry Hines Blvd
Dallas, TX 75390-4228

Mailing address

P.O.Box 845347
Dallas, TX 75284-7208

Other practice location 1

1501 Kings Hwy
Department of Medicine
Shreveport, LA 71103-4228
Phone (318) 675-5000

Other identifiers 1

IdentifierTypeStateIssuer
1099937MedicaidLA

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
I20190131000871 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 4789826959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6201 Harry Hines Blvd
Dallas, TX 75390-9032
Phone (214) 633-5555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy43
Upper gastrointestinal (GI) endoscopy for acid reflux51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.203838LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: mboktor168617@direct.swmed.us

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.

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1811187354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753904228",
            "telephone_number": "214-645-6355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "Department of Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-675-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOKTOR",
        "first_name": "MOHEB",
        "middle_name": "NABIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.203838",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "MD.203838",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "R9190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1099937",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.