| Shameem Azizad, MD | |
|
12554 Riata Vista Cir, Austin, TX 78727-6431 | |
| (512) 795-5100 | |
| (512) 795-5122 |
| Full Name | Shameem Azizad |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 17 Years |
| Location | 12554 Riata Vista Cir, Austin, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700020823 | NPI | - | NPPES |
| 3382491-05 | Medicaid | TX | |
| 3382491-03 | Medicaid | TX | |
| 3382491-04 | Medicaid | TX | |
| P01482138 | Other | TX | RAILROAD MEDICARE |
| P9151 | Other | TX | TEXAS MEDICAL LICENSE |
| P01482139 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | P9151 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Hospital Of Kansas City | Kansas city, MO | Hospital |
| Saint Luke's East Hospital | Lees summit, MO | Hospital |
| Saint Luke's South Hospital | Overland park, KS | Hospital |
| Saint Lukes North Hospital | Kansas city, MO | Hospital |
| Wright Memorial Hospital | Trenton, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Lukes Physician Group Inc | 3577476894 | 1234 |
| Saint Lukes Physician Group Inc | 3577476894 | 1234 |
| Saint Lukes Physician Group Inc | 3577476894 | 1234 |
| Entity Name | Saint Lukes Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093263717 PECOS PAC ID: 3577476894 Enrollment ID: O20031111000818 |
| Mailing Address | Practice Location Address |
|---|---|
| Shameem Azizad, MD 12554 Riata Vista Cir, Austin, TX 78727-6431 Ph: (512) 795-5100 | Shameem Azizad, MD 12554 Riata Vista Cir, Austin, TX 78727-6431 Ph: (512) 795-5100 |
Jason R. Wallace, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Gregory Connor, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Cir, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Catherine Suchia Wu, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4101 James Casey Blvd, #100, Austin, TX 78745 Phone: 512-447-2202 Fax: 512-447-5337 | |
Dr. Michael Troy Harper, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Ian L. Love, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 8038 Mesa Dr, Austin, TX 78731 Phone: 512-901-8748 Fax: 512-901-8755 | |
Dr. Bradley Brenner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12554 Riata Vista Cir, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 | |
Dr. Gordon A. Witwer, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 12554 Riata Vista Circle, Austin, TX 78727 Phone: 512-795-5100 Fax: 512-795-5122 |