Individual provider Active NPI

Roland Martial Tsopze, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1184137614
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP135750 Issued in TX
Practice address
18383 Preston Rd Ste 202
Dallas, TX 75252-5487
Phone
(469) 546-5539
Fax
(469) 546-9581
NPI assigned
Nov 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP135750 TX Primary

Addresses

Primary practice location

18383 Preston Rd Ste 202
Dallas, TX 75252-5487

Mailing address

18383 Preston Rd Ste 202
Dallas, TX 75252-5487
Phone (469) 546-5539

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
I20180222001412 TX Practitioner - Nurse Practitioner 1355602962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18383 Preston Rd
Suite 202
Dallas, TX 75252-5487
Phone (469) 546-5539

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Psychiatric Management LLC Psychiatric/Mental Health CurrentSince Oct 1, 2022 Accepting new patients

Locations

18383 Preston Rd
Ste 202
Dallas, TX 75252
Phone (469) 546-5539

Interoperability endpoints

  • Direct secure messaging: roland.tsopze.pmhnp-bc.1@27418.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1184137614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18383 PRESTON RD STE 202",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525487",
            "telephone_number": "469-546-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18383 PRESTON RD STE 202",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525487",
            "telephone_number": "469-546-5539",
            "fax_number": "469-546-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSOPZE",
        "first_name": "ROLAND",
        "middle_name": "MARTIAL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP135750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.