Individual provider Active NPI

Asma Ashiqali Bhaidani, PA-C

  • Physician Assistant
  • Carrollton, TX
National Provider Identifier
1861623951
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07856 Issued in TX
Practice address
4125 Fairway Dr Ste 190
Carrollton, TX 75010
Phone
(469) 431-0486
Fax
(972) 395-3383
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA07856 TX Primary
Physician Assistant 363A00000X 085003389 IL

Addresses

Primary practice location

4125 Fairway Dr Ste 190
Carrollton, TX 75010

Mailing address

4125 Fairway Dr Ste 190
Carrollton, TX 75010-6506
Phone (469) 431-0486

Other practice location 1

2600 Eldorado Pkwy Ste 100
McKinney, TX 75070-7517
Phone (847) 414-7228

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150122000501 TX Practitioner - Physician Assistant 9830413814 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085003389ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stella Mattina Health Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1861623951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 FAIRWAY DR STE 190",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106506",
            "telephone_number": "469-431-0486",
            "fax_number": "972-395-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 FAIRWAY DR STE 190",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "469-431-0486",
            "fax_number": "972-395-3383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Eldorado Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "750707517",
            "country_code": "US",
            "telephone_number": "847-414-7228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHAIDANI",
        "first_name": "ASMA",
        "middle_name": "ASHIQALI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07856",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003389",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.