Individual provider Active NPI

Ghian Fhillipe Pieraldi Vassallo, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1508512997
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38938 Issued in TX
Practice address
7272 Wurzbach Rd Ste 706
San Antonio, TX 78240-4803
Phone
(210) 615-3483
NPI assigned
Feb 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38938 TX Primary

Addresses

Primary practice location

7272 Wurzbach Rd Ste 706
San Antonio, TX 78240-4803

Mailing address

10800 Lakeline Blvd Apt 6303
Austin, TX 78717-1080

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220315002035 TX Practitioner - Clinical Psychologist 3678968336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38938TXMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicultural Behavioral Health of Texas Current Accepting new patients
Deer Oaks Geriatric Services P C Clinical CurrentSince Mar 2, 2022 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical PastSince Feb 27, 2022 Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

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": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1508512997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 LAKELINE BLVD APT 6303",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787171080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD STE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404803",
            "telephone_number": "210-615-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERALDI VASSALLO",
        "first_name": "GHIAN",
        "middle_name": "FHILLIPE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.