Individual provider Active NPI

Monalisa Bera

  • Gerontology Nurse Practitioner
  • Katy, TX
National Provider Identifier
1316688245
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP1073014 Issued in TX
Practice address
24285 Katy Fwy Ste 300
Katy, TX 77494-1327
Phone
(346) 387-7171
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP1073014 TX Primary

Addresses

Primary practice location

24285 Katy Fwy Ste 300
Katy, TX 77494-1327

Mailing address

5415 Mustang Ridge LN
Fulshear, TX 77441-2139
Phone (281) 723-0666

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
I20220422001716 TX Practitioner - Nurse Practitioner 9133516016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collaborative Geriatrics IncGroup PAC ID 5193827046, 45 clinicians

Practice addresses (Care Compare)

24285 Katy Fwy
Suite 300
Katy, TX 77494-1327
Phone (346) 387-7171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP1073014TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Geriatrics Inc Gerontology CurrentSince Apr 6, 2022 Accepting new patients

Locations

24285 Katy Fwy
Ste 300
Katy, TX 77494
Phone (346) 387-7171

1405 Valhalla Dr
Wharton, TX 77488
Phone (713) 723-9068

Organizations & group practices 1

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 1

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1316688245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 MUSTANG RIDGE LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774412139",
            "telephone_number": "281-723-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941327",
            "telephone_number": "346-387-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERA",
        "first_name": "MONALISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP1073014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.