Organization Active NPI

Elite Care Internal Medicine PLLC

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1902630395
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ELITE CARE INTERNAL MEDICINE PLLC
Practice address
4017 E Plano Pkwy Ste 400
Plano, TX 75074-1841
Phone
(918) 501-9913
NPI assigned
Aug 28, 2024
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
MHD Yasser Darkazally, MD
Title
Authorized Official
Phone
(918) 501-9913

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

4017 E Plano Pkwy Ste 400
Plano, TX 75074-1841

Mailing address

4017 E Plano Pkwy Ste 400
Plano, TX 75074-1841
Phone (918) 501-9913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912000257 TX Part B Supplier - Clinic/Group Practice 7214477694 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

4017 E Plano Pkwy
Ste 400
Plano, TX 75074
Phone (817) 662-4975

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1902630395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4017 E PLANO PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750741841",
            "telephone_number": "918-501-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 E PLANO PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750741841",
            "telephone_number": "918-501-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CARE INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "DARKAZALLY",
        "authorized_official_first_name": "MHD",
        "authorized_official_middle_name": "YASSER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "918-501-9913",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.