NPIMap

Individual provider Active NPI

Samer Izzat Jifi-Bahlool, MD

  • Nephrology Physician
  • Corpus Christi, TX
National Provider Identifier
1881621118
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
L0304 Issued in TX
Practice address
614 Furman Ave
Corpus Christi, TX 78404-2325
Phone
(361) 882-9278
Fax
(361) 882-9279
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X L0304 TX Primary
Specialist 174400000X L0304 TX

Addresses

Primary practice location

614 Furman Ave
Corpus Christi, TX 78404-2325

Mailing address

PO Box 60041
Corpus Christi, TX 78466-0041
Phone (361) 882-9278

Other identifiers 2

IdentifierTypeStateIssuer
74-2617515OtherTXTAX ID
046256601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070409000298 TX Practitioner - NephrologyPractitioner - Internal Medicine 4183650765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bay Area Kidney Disease Physicians, PLLCGroup PAC ID 2860478815, 9 clinicians

Practice addresses (Care Compare)

614 Furman Ave
Corpus Christi, TX 78404-2325
Phone (361) 882-9278

Hospital & facility affiliations

  • Bay Area Dialysis Services at Aransas Pass Dialysis facility, Aransas Pass, TX, CCN 452645
  • Fresenius Medical Care Rockport Dialysis facility, Rockport, TX, CCN 672603
  • Bay Area Dialysis Corpus Christi Dialysis facility, Corpus Christi, TX, CCN 452619
  • FKC Corpus Christi Home Dialysis facility, Corpus Christi, TX, CCN 742558
  • Fresenius Medical Care Calallen Dialysis facility, Robstown, TX, CCN 452630
  • Christus Spohn Hospital Corpus Christi Hospital, Corpus Christi, TX, CCN 450046
  • Corpus Christi Medical Center,the Hospital, Corpus Christi, TX, CCN 450788

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dialysis Access Center, LLP Nephrology PastSince Oct 30, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sjifibahlool24187@direct.acumenmd.com

Organizations & group practices 2

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 6

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1881621118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60041",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784660041",
            "telephone_number": "361-882-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 FURMAN AVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042325",
            "telephone_number": "361-882-9278",
            "fax_number": "361-882-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIFI-BAHLOOL",
        "first_name": "SAMER",
        "middle_name": "IZZAT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "L0304",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L0304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "74-2617515",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046256601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.