Organization Active NPI

Healthy Me Clinic PLLC

  • Internal Medicine Physician
  • Mansfield, TX
National Provider Identifier
1205616612
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHY ME CLINIC PLLC
Practice address
120 N Miller Rd Ste 200
Mansfield, TX 76063-9106
Phone
(903) 932-7574
Fax
(302) 329-6662
NPI assigned
Oct 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Dr. Yousif A Hani, MD
Title
Ceo
Phone
(903) 932-7574

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

120 N Miller Rd Ste 200
Mansfield, TX 76063-9106

Mailing address

120 N Miller Rd Ste 200
Mansfield, TX 76063-9106
Phone (903) 932-7574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231108000703 TX Part B Supplier - Clinic/Group Practice 8123475415 Receives reassigned benefits from 4 practitioners
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

5901 S Cooper St
Ste 111
Arlington, TX 76017

120 N Miller Rd
Ste 200
Mansfield, TX 76063
Phone (469) 935-6373

120 N Miller Rd
Mansfield, TX 76063

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1205616612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MILLER RD STE 200",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639106",
            "telephone_number": "903-932-7574",
            "fax_number": "302-329-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MILLER RD STE 200",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639106",
            "telephone_number": "903-932-7574",
            "fax_number": "302-329-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY ME CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "HANI",
        "authorized_official_first_name": "YOUSIF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-932-7574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.