Individual provider Active NPI

Sareena Siyas, MD

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1861953325
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T9251 Issued in TX
Practice address
2520 W I 20
Grand Prairie, TX 75052-7280
Phone
(972) 264-5858
NPI assigned
Mar 27, 2019
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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
Family Medicine Physician 207Q00000X T9251 TX Primary

Addresses

Primary practice location

2520 W I 20
Grand Prairie, TX 75052-7280

Mailing address

611 E State Highway 121 Ste 220
Coppell, TX 75019-7958

Other practice location 1

205 E Toronto Ave
McAllen, TX 78503-1209
Phone (956) 687-6155

Other names 1

  • Sareena Aboobacker Abdulla Former name

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
I20231003000512 TX Practitioner - Family Practice 5991130312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuropathy Pain Clinic of Fort Worth LLCGroup PAC ID 4688866015, 16 clinicians

Practice addresses (Care Compare)

4544 Spring Stuebner Rd
Suite 100
Spring, TX 77389-1117
Phone (832) 924-6093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9251TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners of Arizona, P.C. Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Primary Health Physicians, PLLC CurrentSince Sep 5, 2024 Accepting new patients
Graybill Medical Group Inc Family Medicine PastSince Aug 28, 2022 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

512 W Rosedale St
Fort Worth, TX 76104
Phone (817) 289-8263

2520 W Interstate 20
Grand Prairie, TX 75052
Phone (972) 264-5858

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sareena.siyas.1@32527.direct.athenahealth.com
  • Direct secure messaging: sareena.siyas.p5@direct.caremoreagp.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1861953325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E STATE HIGHWAY 121 STE 220",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 W I 20",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527280",
            "telephone_number": "972-264-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 E Toronto Ave",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785031209",
            "country_code": "US",
            "telephone_number": "956-687-6155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIYAS",
        "first_name": "SAREENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAREENA",
            "last_name": "ABOOBACKER ABDULLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.