Individual provider Active NPI

Aneeqa Shamshad Butt

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1831678226
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T1309 Issued in TX
Practice address
4115 E Lancaster Ave
Fort Worth, TX 76103-3614
Phone
(817) 796-7370
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T1309 TX Primary

Addresses

Primary practice location

4115 E Lancaster Ave
Fort Worth, TX 76103-3614

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 547-3456

Other practice location 1

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

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
I20220815001864 TX Practitioner - Internal Medicine 3476936071 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians

Practice addresses (Care Compare)

1950 Ephriham Ave
Fort Worth, TX 76164-6670
Phone (817) 813-7075

4115 E Lancaster Ave
Fort Worth, TX 76103-3614
Phone (817) 796-7370

819 E Abram St
Arlington, TX 76010-1212
Phone (817) 841-8997

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heal 360 Primary Care PLLC CurrentSince Jul 1, 2022 Accepting new patients
Heal 360 Urgent Care, LLC CurrentSince Jul 1, 2022 Accepting new patients
Oak Street Health of Texas, PLLC Internal Medicine CurrentSince Jun 12, 2023 Accepting new patients

Locations

2301 N Collins St
Ste 118
Arlington, TX 76011
Phone (214) 556-8887

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

3320 Lavon Dr
Garland, TX 75040
Phone (972) 200-2595

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

1360 Star Ct
Ste T1
Plano, TX 75074
Phone (972) 200-7402

4013 14th St
Ste 401
Plano, TX 75074
Phone (469) 814-9523

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

2806 W FM 544
Wylie, TX 75098

Interoperability endpoints

  • Direct secure messaging: abutt323643@bassett.direct-ci.net

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1831678226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-3456",
            "fax_number": "607-547-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033614",
            "telephone_number": "817-796-7370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "133261301",
            "country_code": "US",
            "telephone_number": "607-547-3456",
            "fax_number": "607-547-6612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTT",
        "first_name": "ANEEQA",
        "middle_name": "SHAMSHAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T1309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.