Individual provider Active NPI

Melissa Ann De Los Santos, MSN, ACNP-BC

  • Acute Care Nurse Practitioner
  • Irving, TX
National Provider Identifier
1124329024
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
688661 Issued in TX
Practice address
1432 Caneel CT
Irving, TX 75060-4495
Phone
(214) 470-5591
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 688661 TX Primary

Addresses

Primary practice location

1432 Caneel CT
Irving, TX 75060-4495

Mailing address

1432 Caneel CT
Irving, TX 75060-4495
Phone (214) 470-5591

Other identifiers 1

IdentifierTypeStateIssuer
284553901MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdelossantos438364@direct.sw.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000559 TX Practitioner - Nurse Practitioner 9830361229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4421 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-1752
Phone (469) 800-4540

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
  • The Heart Hospital Baylor Denton Hospital, Denton, TX, CCN 450893
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
688661TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Jul 13, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 13, 2019 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

3600 Gaston Ave
Ste 558
Dallas, TX 75246

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3333 Colorado Blvd
Denton, TX 76210
Phone (940) 381-2199

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1124329024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 CANEEL CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750604495",
            "telephone_number": "214-470-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 CANEEL CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750604495",
            "telephone_number": "214-470-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "688661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284553901",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdelossantos438364@direct.sw.org",
            "affiliation": "N",
            "address_1": "4421 Long Prairie Rd Ste 100",
            "city": "Flower Mound",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750281752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.