NPIMap

Individual provider Active NPI

Mary Ellen Vanderlick, MD

  • Neurology Physician
  • Bellaire, TX
National Provider Identifier
1144285842
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
K6386 Issued in TX
Practice address
6700 West Loop S Ste 400
Bellaire, TX 77401-4120
Phone
(713) 704-6731
Fax
(713) 704-1796
NPI assigned
Apr 18, 2006
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X K6386 TX Primary

Addresses

Primary practice location

6700 West Loop S Ste 400
Bellaire, TX 77401-4120

Mailing address

6700 West Loop S Ste 400
Bellaire, TX 77401-4120
Phone (713) 795-4785

Other identifiers 3

IdentifierTypeStateIssuer
00106WOtherTXMISCHER GRP MDCR PTAN HARRIS CO
0035TDOtherTXMISCHER BCBSTX GRP PROV REC
153449704OtherTXMISCHER GRP MDCD HARRIS CO TPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000485 TX Practitioner - Neurology 8527109347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Louisiana State University School of Medicine in Shreveport, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MHS Physicians of TexasGroup PAC ID 1557254968, 113 clinicians

Practice addresses (Care Compare)

18955 N Memorial Dr
Suite 360
Humble, TX 77338-4396
Phone (281) 319-8530

6700 W Loop S
Suite 400
Bellaire, TX 77401-4120
Phone (713) 795-4785

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6386TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Neighborhood Health Centers, PLLC Neurology Current Accepting new patients
MHS Physicians of Texas CurrentSince Jul 1, 2013 Accepting new patients
MHS Physicians of Texas Neurology CurrentSince Jul 1, 2013 Accepting new patients

Locations

6700 West Loop S
Ste 400
Bellaire, TX 77401
Phone (713) 704-6731

6400 Fannin St
Ste 2070
Houston, TX 77030
Phone (713) 704-6731

18955 N Memorial Dr
Ste 360
Humble, TX 77338
Phone (281) 319-8530

Interoperability endpoints

  • Direct secure messaging: mvanderlick66985@memorialhermann.direct-ci.com

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1144285842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 WEST LOOP S STE 400",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014120",
            "telephone_number": "713-795-4785",
            "fax_number": "713-795-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 WEST LOOP S STE 400",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014120",
            "telephone_number": "713-704-6731",
            "fax_number": "713-704-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERLICK",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "K6386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISCHER GRP MDCR PTAN HARRIS CO",
            "identifier": "00106W",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISCHER BCBSTX GRP PROV REC",
            "identifier": "0035TD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISCHER GRP MDCD HARRIS CO TPI",
            "identifier": "153449704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.