Shielamae N. Carbullido, A-GNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1129827 Issued in TX

Practice address

3035 Stillhouse Lake Rd,
Harker Heights, TX 76548

Phone

(254) 519-8922

NPI assigned

Aug 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.04 of 100Reported as group

Quality

76.6

Promoting interoperability

100

Improvement activities

40

Cost

73.53

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: scarbullido720019@adventhealth.direct-ci.com

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.

• Metroplex Clinic Physicians, Inc.

  • Urology Physician
  • Killeen, TX
  • NPI 1891730396
  Medicare reassignment NPD

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1104600691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 JESTER CT",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765228102",
            "telephone_number": "254-981-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 STILLHOUSE LAKE RD,",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "76548",
            "telephone_number": "254-519-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBULLIDO",
        "first_name": "SHIELAMAE",
        "middle_name": "N.",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1129827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Campbell, RBT
• Michael E. Campbell, PH.D.
• Orlando Campbell, PT, DPT
• Cara Adele Cannell, MD
• Carlo Carandang, MD
• Amber Cardoza
• Carl R Darnall Army Medical Center
• Mykaylah Carngbe, RBT
• Sarah Carpenter, OTR
• Bradley W. Carpentier, M.D.

• Primary Care Nurse Practitioner in Harker Heights, TX
• Providers in Harker Heights, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.

Verify at the official NPI Registry.