Individual provider Active NPI

Ava Hajivandi

  • Medical Physician Assistant
  • Dallas, TX
National Provider Identifier
1962119768
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18009 Issued in TX
Practice address
7777 Forest LN Ste 614
Dallas, TX 75230-2571
Phone
(972) 566-7499
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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
Medical Physician Assistant 363AM0700X PA18009 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste 614
Dallas, TX 75230-2571

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722004094 TX Practitioner - Physician Assistant 1153867593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

3410 Worth St
Dallas, TX 75246-2092

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

7777 Forest LN
Suite C204
Dallas, TX 75230-6833
Phone (972) 566-7499

7777 Forest LN
Suite C614
Dallas, TX 75230-6856
Phone (972) 566-7499

7777 Forest LN
Suite C707
Dallas, TX 75230-6861
Phone (972) 566-3000

7777 Forest LN
Suite C850
Dallas, TX 75230-6902
Phone (972) 566-7766

7848 Gateway Blvd E
El Paso, TX 79915-1815
Phone (915) 599-1313

PO Box
Suite 911242
Dallas, TX 75391-1242

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18009TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Jul 8, 2024 Accepting new patients
Texas Oncology PA PastSince Sep 15, 2024 Accepting new patients

Locations

7777 Forest Ln
Ste C614
Dallas, TX 75230
Phone (972) 566-7499

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

Interoperability endpoints

  • Direct secure messaging: ava.hajivandi@txo.ikm.direct-ci.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 7

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": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1962119768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE 614",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "972-566-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJIVANDI",
        "first_name": "AVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA18009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.