Individual provider Active NPI

Sidra Qureshi, MD

  • Internal Medicine Physician
  • Galveston, TX
National Provider Identifier
1902226954
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2447 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0570
Phone
(409) 772-7063
Fax
(409) 747-8579
NPI assigned
Apr 17, 2014
Last updated
Apr 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R2447 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0570

Mailing address

301 University Blvd
Galveston, TX 77555-0570
Phone (409) 772-2653

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
I20170711003081 TX Practitioner - Internal Medicine 0244509966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2447TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice Internal Medicine CurrentSince Jun 7, 2017 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

Interoperability endpoints

  • Direct secure messaging: squreshimd27042@direct.utmb.edu

Organizations & group practices 1

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.

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1902226954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550570",
            "telephone_number": "409-772-2653",
            "fax_number": "409-772-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550570",
            "telephone_number": "409-772-7063",
            "fax_number": "409-747-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "SIDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R2447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.