Individual provider Active NPI

Stormy O Valdespino, FNP-C, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1164684254
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
117236 Issued in TX
Practice address
1200 Brooklyn Ave Ste 150
San Antonio, TX 78212-4815
Phone
(210) 560-5841
Fax
(201) 462-3853
NPI assigned
Jun 30, 2008
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 659602 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 117236 TX Primary

Addresses

Primary practice location

1200 Brooklyn Ave Ste 150
San Antonio, TX 78212-4815

Mailing address

1200 Brooklyn Ave Ste 150
San Antonio, TX 78212-4815
Phone (210) 560-5841

Other identifiers 1

IdentifierTypeStateIssuer
8580MBOtherTXBCBS-TX

Other names 1

  • Stormy Mendoza Former name

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
I20081024000368 TX Practitioner - Nurse Practitioner 6507924214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Texas, PLLCGroup PAC ID 7618237264, 398 clinicians

Practice addresses (Care Compare)

1401 Medical Pkwy
Cedar Park, TX 78613-7763
Phone (512) 528-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
117236TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 24, 2024 Accepting new patients
Mind Matters Psychiatric Clinic PLLC Psychiatric/Mental Health Current Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Mind Matters Psychiatric Clinic PLLC Family CurrentSince Nov 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

1200 Brooklyn Ave
Ste 150
San Antonio, TX 78212
Phone (210) 212-4114

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1164684254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124815",
            "telephone_number": "210-560-5841",
            "fax_number": "201-462-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124815",
            "telephone_number": "210-560-5841",
            "fax_number": "201-462-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDESPINO",
        "first_name": "STORMY",
        "middle_name": "O",
        "credential": "FNP-C,  PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "659602",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "117236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-TX",
            "identifier": "8580MB",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STORMY",
            "last_name": "MENDOZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.