Individual provider Active NPI

Henry Ehizokhale, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1205593852
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403900 Issued in NY
Practice address
4407 Emerald Leaf Dr
Mansfield, TX 76063-5545
Phone
(443) 600-8858
NPI assigned
Nov 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 950273 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61239833 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403900 NY Primary

Addresses

Primary practice location

4407 Emerald Leaf Dr
Mansfield, TX 76063-5545

Mailing address

134 N 4TH Street, Brooklyn, Ny 11249
Brooklyn, NY 11249

Other practice location 1

424 W Bakerview Rd Ste 105-2092
Bellingham, WA 98226-8176
Phone (443) 600-8858

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherTXHENRY EHIZOKHALE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220426000438 NY Practitioner - Nurse Practitioner 0547657322 Reassigns benefits to 2 organizations
I20220805002875 WA Practitioner - Nurse Practitioner 0547657322 Reassigns benefits to 3 organizations
I20221123002787 TX Practitioner - Nurse Practitioner 0547657322 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

1455 NW Leary Way
Suite 400
Seattle, WA 98107-5138
Phone (646) 450-7748

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
950273TXMDRegistered Nurse
AP61239833WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Psychiatric/Mental Health CurrentSince Mar 1, 2022 Accepting new patients
Valera Medical, P.a. Psychiatric/Mental Health CurrentSince Oct 1, 2022 Accepting new patients
Essex County Treasurer CurrentSince Feb 8, 2023 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Multicare Health System CurrentSince Sep 23, 2022 Accepting new patients
Multicare Health System CurrentSince Sep 23, 2022 Accepting new patients
Brightside Medical, P.C. CurrentSince Apr 1, 2023 Accepting new patients
Essex County Treasurer CurrentSince Feb 8, 2023 Accepting new patients
Abi-Care LLC Current Accepting new patients
Multicare Health System Current Accepting new patients

Locations

2550 W Union Hills Dr
Ste 350
Phoenix, AZ 85027
Phone (480) 404-4952

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

134 N 4th St
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 11

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": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1205593852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 4TH STREET, BROOKLYN, NY 11249",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 EMERALD LEAF DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635545",
            "telephone_number": "443-600-8858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 W Bakerview Rd Ste 105-2092",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982268176",
            "country_code": "US",
            "telephone_number": "443-600-8858",
            "fax_number": "817-225-2492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EHIZOKHALE",
        "first_name": "HENRY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-18",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "950273",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61239833",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HENRY EHIZOKHALE",
            "identifier": "NONE",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "4407 Emerald Leaf Dr",
            "city": "Mansfield",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760635545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.