Individual provider Active NPI

Diana Brosten Mannschreck, MD

  • Dermatology Physician
  • Kingwood, TX
National Provider Identifier
1235595166
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
U5162 Issued in TX
Practice address
4505 Kingwood Dr Ste 185
Kingwood, TX 77345-2618
Phone
(281) 612-0050
Fax
(281) 612-0051
NPI assigned
Jan 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X U5162 TX Primary

Addresses

Primary practice location

4505 Kingwood Dr Ste 185
Kingwood, TX 77345-2618

Mailing address

27131 Fulshear Bend Dr
Fulshear, TX 77441-1231
Phone (281) 612-0050

Other names 1

  • Diana Camille Brosten 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906003031 TX Practitioner - Dermatology 1557794583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Johns Hopkins University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Dermatology, PLLCGroup PAC ID 8729345285, 26 clinicians

Practice addresses (Care Compare)

4505 Kingwood Dr
Suite 185
Kingwood, TX 77345-2618
Phone (281) 747-5533

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision50
Removal of skin lesions815
Removal or shaving of skin growth11
Skin biopsy630

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dermatology, PLLC Dermatology CurrentSince Aug 1, 2023 Accepting new patients
Elite Derm Services, PLLC CurrentSince Dec 22, 2024 Accepting new patients
Hughston Clinic, P.C. Past Accepting new patients

Locations

27131 Fulshear Bend Dr
Fulshear, TX 77441
Phone (281) 612-0050

20326 State Highway 249
Ste 400
Houston, TX 77070
Phone (281) 501-5599

4505 Kingwood Dr
Ste 185
Kingwood, TX 77345
Phone (281) 747-5533

1930 Pearland Pkwy
Ste 154
Pearland, TX 77581
Phone (281) 816-5503

Interoperability endpoints

  • Direct secure messaging: dmann@elitedermatology.emadirect.md
  • Direct secure messaging: dmannschreck253732@directhisp.wakemed.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1235595166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27131 FULSHEAR BEND DR",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774411231",
            "telephone_number": "281-612-0050",
            "fax_number": "281-612-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 KINGWOOD DR STE 185",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452618",
            "telephone_number": "281-612-0050",
            "fax_number": "281-612-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNSCHRECK",
        "first_name": "DIANA",
        "middle_name": "BROSTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "U5162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BROSTEN",
            "middle_name": "CAMILLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.