Individual provider Active NPI

Kamdin Poorkiyani

  • General Practice Physician
  • Abilene, TX
National Provider Identifier
1831680941
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
T8018 Issued in TX
Practice address
2501 Maple Street
Abilene, TX 79602-5058
Phone
(325) 692-4053
Fax
(325) 795-3037
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58.030252 OH
General Practice Physician 208D00000X T8018 TX Primary

Addresses

Primary practice location

2501 Maple Street
Abilene, TX 79602-5058

Mailing address

6573 Shoreline Dr
Little Elm, TX 75068-3115
Phone (440) 585-6400

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
I20230324000246 TX Practitioner - General Practice 4587034731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health and Human Services CommissionGroup PAC ID 2163795824, 138 clinicians

Practice addresses (Care Compare)

2501 Maple St
Abilene, TX 79602-5058
Phone (325) 795-3515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.030252OHMDInternal Medicine Physician
T8018TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission Internal Medicine CurrentSince Dec 8, 2022 Accepting new patients
Health and Human Services Commission CurrentSince Dec 8, 2022 Accepting new patients
Health and Human Services Commission General Practice Current Accepting new patients
Health and Human Services Commission General Practice Current Accepting new patients

Locations

2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053

4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327

6711 S New Braunfels Ave
Ste 100
San Antonio, TX 78223
Phone (210) 531-7805

6711 S New Braunfels Ave
Ste 1
San Antonio, TX 78223
Phone (210) 532-8811

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831680941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6573 SHORELINE DR",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750683115",
            "telephone_number": "440-585-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 MAPLE STREET",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796025058",
            "telephone_number": "325-692-4053",
            "fax_number": "325-795-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORKIYANI",
        "first_name": "KAMDIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "58.030252",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T8018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.