Individual provider Active NPI

Nima M Pourrajabi, DO

  • Emergency Medicine Physician
  • Bryan, TX
National Provider Identifier
1811923006
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U1356 Issued in TX
Practice address
2801 Franciscan Dr
Bryan, TX 77802-2544
Phone
(979) 776-3777
NPI assigned
Jun 23, 2006
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA04598 TX
Emergency Medicine Physician 207P00000X U1356 TX Primary

Addresses

Primary practice location

2801 Franciscan Dr
Bryan, TX 77802-2544

Mailing address

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-3777

Other practice location 1

1604 Rock Prairie Rd
College Station, TX 77845-8345
Phone (979) 764-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060314000364 TX Practitioner - Physician Assistant 9830106079
I20230918000551 TX Practitioner - Emergency Medicine 9830106079 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cec Lakeway Urgent Care Physicians PLLCGroup PAC ID 8123318169, 12 clinicians
Third Coast Emergency Physicians Southwest PAGroup PAC ID 6800794447, 38 clinicians

Practice addresses (Care Compare)

1518 Ranch Rd 620
Suite 100
Lakeway, TX 78734-6291
Phone (817) 527-3403

4103 N Loop 1604
San Antonio, TX 78249-1395
Phone (210) 572-8415

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
96.16
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.59 of 100Reported as group
Quality
90.83
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
U1356TXMDEmergency Medicine Physician
PA04598TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tec Emergency Physicians, PLLC CurrentSince Oct 24, 2024 Accepting new patients
Bryan Emergency Physicians PA Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Jan 5, 2024 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Dec 5, 2023 Accepting new patients
Brazos Valley Emergency Physicians PA Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Lakeway Era Acquistion Partners LLC Past Accepting new patients
Traditions Emergency Medicine PA Past Accepting new patients
Westlake Complete Care LLC Past Accepting new patients

Locations

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

100 W Cross St
Madisonville, TX 77864
Phone (409) 348-2631

210 S Judson St
Navasota, TX 77868
Phone (936) 825-6585

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

11320 Alamo Ranch Pkwy
San Antonio, TX 78253
Phone (210) 485-3644

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12515/brand/6/csg/1/fhir/r4

Organizations & group practices 9

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 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1811923006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 FRANCISCAN DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022544",
            "telephone_number": "979-776-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FRANCISCAN DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022544",
            "telephone_number": "979-776-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1604 Rock Prairie Rd",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778458345",
            "country_code": "US",
            "telephone_number": "979-764-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POURRAJABI",
        "first_name": "NIMA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04598",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U1356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.