Individual provider Active NPI

Soad Michelsen, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1043327703
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
L5052 Issued in TX
Practice address
8535 Tom Slick
San Antonio, TX 78229-3367
Phone
(210) 582-6440
Fax
(210) 692-9021
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X L5052 TX Primary
Psychiatry Physician 2084P0800X L5052 TX

Addresses

Primary practice location

8535 Tom Slick
San Antonio, TX 78229-3367

Mailing address

8535 Tom Slick
San Antonio, TX 78229-3367
Phone (210) 582-6440

Other identifiers 1

IdentifierTypeStateIssuer
0154055101MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120511000279 TX Practitioner - Psychiatry 7911160825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8550 Huebner Rd
San Antonio, TX 78240-1803
Phone (210) 541-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5052TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sensus Psychiatric Solutions PLLC Child & Adolescent Psychiatry CurrentSince Mar 6, 2019 Accepting new patients
San Antonio Behavioral Healthcare Hospital, LLC Past Accepting new patients

Locations

8535 Tom Slick
San Antonio, TX 78229
Phone (210) 582-6440

10250 John Saunders Rd
Unit 460625
San Antonio, TX 78246

8550 Huebner Rd
San Antonio, TX 78240
Phone (210) 229-9085

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1043327703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-582-6440",
            "fax_number": "210-692-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-582-6440",
            "fax_number": "210-692-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSEN",
        "first_name": "SOAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "L5052",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L5052",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154055101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.