Active NPI
Mahta Ostadian, M.D.
- Psychiatry Physician
- Southlake, TX
National Provider Identifier
1003044595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- N2703
- Practice address
- 541 Silicon Dr Ste 102
Southlake, TX 76092 - Phone
- (817) 539-6819
- Fax
- (817) 539-6870
- NPI assigned
- Jun 23, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD60170098 | WA | |
| Psychiatry Physician | 2084P0800X | N2703 | TX | Primary |
Addresses
Primary practice location
541 Silicon Dr Ste 102
Southlake, TX 76092
Mailing address
541 Silicon Dr Ste 102
Southlake, TX 76092-7565
Phone (817) 539-6819
Other practice location 1
11201 SE 8th St
Suite 105
Bellevue, WA 98004-6455
Phone (425) 454-0255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 29, 2020 through Jun 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Pointe Behavioral Health Service, Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Friendswood, TX
- NPI 1114000353
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572220800000",
"number": "1003044595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 SILICON DR STE 102",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927565",
"telephone_number": "817-539-6819",
"fax_number": "817-539-6870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 SILICON DR STE 102",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "76092",
"telephone_number": "817-539-6819",
"fax_number": "817-539-6870"
}
],
"practiceLocations": [
{
"address_1": "11201 SE 8th St",
"address_2": "Suite 105",
"address_purpose": "LOCATION",
"city": "Bellevue",
"state": "WA",
"postal_code": "980046455",
"country_code": "US",
"telephone_number": "425-454-0255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OSTADIAN",
"first_name": "MAHTA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-23",
"last_updated": "2019-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD60170098",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "N2703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.