Active NPI
Khondoker Alam, M.D
- Neurology Physician
- Lubbock, TX
National Provider Identifier
1992185201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- BP10052507
- Practice address
- 3506 21St St Ste 400
Lubbock, TX 79410-1200 - Phone
- (806) 725-4115
- Fax
- (806) 723-7007
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | BP10052507 | TX | Primary |
Addresses
Primary practice location
3506 21St St Ste 400
Lubbock, TX 79410-1200
Mailing address
2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844
Other practice location 1
3601 4th St
Stop 8321
Lubbock, TX 79430-0002
Phone (806) 743-2391
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 414068301 | Medicaid | TX | |
| 1F4352 | Other | TX | MEDICARE |
| 8MY723 | Other | TX | BCBS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200806003852 | TX | Practitioner - Neurology | 6608174057 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Texas Tech University Health Science Center School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Medical Group
Practice addresses (Care Compare)
3506 21St St
Suite 400
Lubbock, TX 79410-1212
Phone (806) 725-4115
Hospital & facility affiliations
- Covenant Medical Center
- Covenant Hospital Plainview
- University Medical Center
- Covenant Childrens Hospital
- Ut of Texas Southwestern University Hospital - William P. Clements Jr.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group | Current | Accepting new patients | |
| Covenant Medical Group | Current | Accepting new patients |
Locations
3506 21st St
Ste 400
Lubbock, TX 79410
Phone (806) 725-4115
2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228
3601 4th St
Stop 8321
Lubbock, TX 79430
Phone (806) 743-2391
Interoperability endpoints
- alam.khondoker@direct.myteamcare.com
- kalam1928726@oc.providencedirect.org
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.
-
- Rural Health Clinic/Center
- Abernathy, TX
- NPI 1538412895
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Lubbock, TX
- NPI 1538245717
Hospital
-
- Hearing and Speech Clinic/Center
- Lubbock, TX
- NPI 1831299114
Hospital
-
- General Acute Care Hospital
- Plainview, TX
- NPI 1073580726
Hospital
-
- Ambulatory Surgical Clinic/Center
- Plainview, TX
- NPI 1174630198
Hospital
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1285798918
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1992185201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 NASHVILLE AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101105",
"telephone_number": "806-725-5844",
"fax_number": "806-723-6532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3506 21ST ST STE 400",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101200",
"telephone_number": "806-725-4115",
"fax_number": "806-723-7007"
}
],
"practiceLocations": [
{
"address_1": "3601 4th St",
"address_2": "STOP 8321",
"address_purpose": "LOCATION",
"city": "Lubbock",
"state": "TX",
"postal_code": "794300002",
"country_code": "US",
"telephone_number": "806-743-2391",
"fax_number": "806-743-5687",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALAM",
"first_name": "KHONDOKER",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-02",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TX",
"license": "BP10052507",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "414068301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "1F4352",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8MY723",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.