Angela Y Ellis, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · San Antonio, TX
NPI 1144045832 · NPPES record last updated Jun 13, 2025
Key facts
- NPI
- 1144045832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 1176835 (TX)
- Practice address
- 1009 NW Loop 410
San Antonio, TX 78213-2221 - Phone
- (210) 742-6551
- NPI assigned
- Nov 19, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hillside Primary Care PLLC
Practice addresses (Care Compare)
1009 NW Loop
410 Psych Office
San Antonio, TX 78213-2221
Phone (210) 742-6551
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241211001875 | TX | Practitioner - Nurse Practitioner | 1951837129 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1176835 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillside Primary Care PLLC | Current |
Accepting new patients | |
| Complete Care Partners LLC | Past |
Accepting new patients |
Locations
12881 N Interstate 35
Live Oak, TX 78233
Phone (210) 742-6552
12410 Toepperwein Rd
#O
Live Oak, TX 78233
Phone (210) 659-4425
12881 Toepperwein Rd
#I35
Live Oak, TX 78233
741 Generations Dr
Ste 215
New Braunfels, TX 78130
1009 NW Loop 410
San Antonio, TX 78213
Phone (210) 366-1021
1009 NW Loop 410
Ofc
San Antonio, TX 78213
Phone (210) 742-6551
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1176835 | TX | Yes |
Addresses
Primary practice location
1009 NW Loop 410
San Antonio, TX 78213-2221
Mailing address
12881 N Ih 35
Live Oak, TX 78233-2966
Phone (210) 742-6555
Other providers in San Antonio, TX
- Morgan Claire Stanley Elliott
- Randall David Elliott
- Steven Thomas Elliott
- Symone Elliott
- Andrea Deno Ellis
- Brenna D. Ellis
- Chandra Varner Ellis
- David Dale Ellis
- Dorothy Jane Ellis
- Edward Ellis III
All providers in San Antonio, TX · Psychiatric/Mental Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.