Individual provider Active NPI

Mussarat Shafiq, M.D.

  • Pediatrics Physician
  • Corsicana, TX
National Provider Identifier
1992816995
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N4737 Issued in TX
Practice address
400 Hospital Dr
Ste 208
Corsicana, TX 75110-2489
Phone
(903) 654-4564
Fax
(903) 654-6837
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME93798 FL
Pediatrics Physician 208000000X N4737 TX Primary

Addresses

Primary practice location

400 Hospital Dr
Ste 208
Corsicana, TX 75110-2489

Mailing address

2403 N Laurent St
Victoria, TX 77901-4119
Phone (361) 579-0315

Other identifiers 3

IdentifierTypeStateIssuer
8CF759OtherTXBLUE CROSS
000000552361OtherOHANTHEM/BCBS
273813900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Past Accepting new patients
Regional Employee Assistance Program Inc Pediatrics Past Accepting new patients
Mercy Emergency Care Services, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1992816995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 N LAURENT ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014119",
            "telephone_number": "361-579-0315",
            "fax_number": "361-579-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR",
            "address_2": "STE 208",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-654-4564",
            "fax_number": "903-654-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIQ",
        "first_name": "MUSSARAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME93798",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N4737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8CF759",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/BCBS",
            "identifier": "000000552361",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273813900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.