Individual provider Active NPI

Nicole S Conselman, M.D.

  • Family Medicine Physician
  • Rockwall, TX
National Provider Identifier
1265450118
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L2196 Issued in TX
Practice address
1975 Alpha Dr
Suite 204
Rockwall, TX 75087-4951
Phone
(469) 800-2100
Fax
(469) 800-3310
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L2196 TX
Family Medicine Physician 207Q00000X L2196 TX Primary

Addresses

Primary practice location

1975 Alpha Dr
Suite 204
Rockwall, TX 75087-4951

Mailing address

1975 Alpha Dr
Suite 204
Rockwall, TX 75087-4951
Phone (469) 800-2100

Other identifiers 1

IdentifierTypeStateIssuer
163006301MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nconselman222511@direct.sw.org

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
I20100429000535 TX Practitioner - Family Practice 1153458757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1975 Alpha Dr
Suite 204
Rockwall, TX 75087-4951
Phone (469) 800-2100

4001 Worth St
Dallas, TX 75246-1608

7217 Telecom Pkwy
Garland, TX 75044-2203

7217 Telecom Pkwy
Suite 300
Garland, TX 75044-2206
Phone (469) 800-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Oct 1, 2001 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Oct 1, 2001 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

1975 Alpha Dr
#204
Rockwall, TX 75087
Phone (214) 820-7010

Interoperability endpoints

  • Direct secure messaging: nconselman222511@direct.sw.org

Organizations & group practices 4

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 7

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1265450118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 ALPHA DR",
            "address_2": "SUITE 204",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874951",
            "telephone_number": "469-800-2100",
            "fax_number": "469-800-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 ALPHA DR",
            "address_2": "SUITE 204",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874951",
            "telephone_number": "469-800-2100",
            "fax_number": "469-800-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSELMAN",
        "first_name": "NICOLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L2196",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163006301",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nconselman222511@direct.sw.org",
            "affiliation": "N",
            "address_1": "1975 Alpha Dr",
            "address_2": "Suite 204",
            "city": "Rockwall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750874951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.