Individual provider Active NPI

Ellen Marie Andrews, PHD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1144055500
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
40189 Issued in TX
Practice address
5788 Eckhert Rd
San Antonio, TX 78240-3900
Phone
(210) 450-6450
NPI assigned
Sep 5, 2024
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 40189 TX
Clinical Psychologist 103TC0700X 40189 TX Primary

Addresses

Primary practice location

5788 Eckhert Rd
San Antonio, TX 78240-3900

Mailing address

5788 Eckhert Rd
San Antonio, TX 78240-3900
Phone (104) 507-2222

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241102000446 TX Practitioner - Clinical Psychologist 7719410497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Texas Southwestern Medical School at Dallas, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5788 Eckhert Rd
San Antonio, TX 78240-3900
Phone (210) 450-7222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40189TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Oct 14, 2024 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Oct 14, 2024 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients

Locations

5788 Eckhert Rd
San Antonio, TX 78240
Phone (210) 450-6450

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 567-6405

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1144055500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "104-507-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-450-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "40189",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.