NPIMap

Organization Active NPI

Canopusmd, PLLC

  • Internal Medicine Physician
  • Carrollton, TX
National Provider Identifier
1942716121
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CANOPUSMD, PLLC
Practice address
4221 Medical Pkwy Ste 150
Carrollton, TX 75010-4545
Phone
(901) 826-7075
NPI assigned
Dec 24, 2017
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Bushra Abbasi, MDNPI 1467642009
Title
President
Phone
(901) 826-7075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

4221 Medical Pkwy Ste 150
Carrollton, TX 75010-4545

Mailing address

4221 Medical Pkwy Ste 150
Carrollton, TX 75010-4545
Phone (972) 939-2121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180419001938 TX Part B Supplier - Clinic/Group Practice 9032472329 Receives reassigned benefits from 10 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

4221 Medical Pkwy
Ste 150
Carrollton, TX 75010
Phone (901) 826-7075

Practitioners & affiliated clinicians

Practitioners 10

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": "1514073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1942716121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 MEDICAL PKWY STE 150",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104545",
            "telephone_number": "972-939-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 MEDICAL PKWY STE 150",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104545",
            "telephone_number": "901-826-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANOPUSMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-24",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "ABBASI",
        "authorized_official_first_name": "BUSHRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-826-7075",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.