Individual provider Active NPI

Soumya Mohanan, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1255971214
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
32922 Issued in TX
Practice address
2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone
(512) 341-1000
NPI assigned
Jan 8, 2020
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 32922 TX Primary

Addresses

Primary practice location

2400 Round Rock Ave
Round Rock, TX 78681-4004

Mailing address

112 Brisa Bend Way
Round Rock, TX 78681-1781
Phone (512) 966-3625

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
I20200217003418 TX Practitioner - Nurse Practitioner 6406283233 Reassigns benefits to 5 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
Jason Martin Medical Consulting LLCGroup PAC ID 8325289812, 51 clinicians

Practice addresses (Care Compare)

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000

1373 N Ave C
Elgin Nursing and Rehabilitation Ce
Elgin, TX 78621-1528
Phone (512) 840-1158

260 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7747

4681 College Park
Round Rock, TX 78665-1526
Phone (512) 671-1100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32922TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince May 1, 2020 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Oct 22, 2024 Accepting new patients
Jason Martin Medical Consulting LLC CurrentSince May 1, 2023 Accepting new patients
Aco Jason Martin Medical Consulting CurrentSince Sep 25, 2025 Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

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

5301 Duval Rd
Austin, TX 78727
Phone (512) 326-1141

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1373 N Avenue C
Elgin, TX 78621
Phone (512) 285-2457

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

521 S Heatherwilde Blvd
Pflugerville, TX 78660
Phone (512) 251-9978

2620 Communications Pkwy
Plano, TX 75093
Phone (214) 501-4672

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Organizations & group practices 5

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 4

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": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1255971214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BRISA BEND WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786811781",
            "telephone_number": "512-966-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814004",
            "telephone_number": "512-341-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANAN",
        "first_name": "SOUMYA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "32922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.