Individual provider Active NPI

Simmi Dhalla

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1558080549
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1090339 Issued in TX
Practice address
85 NE Loop 410 Ste 220
San Antonio, TX 78216-5844
Phone
(210) 888-8888
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1090339 TX Primary

Addresses

Primary practice location

85 NE Loop 410 Ste 220
San Antonio, TX 78216-5844

Mailing address

85 NE Loop 410 Ste 220
San Antonio, TX 78216-5844

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
I20221118000245 TX Practitioner - Nurse Practitioner 3274901533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychcare of San Antonio I PLLCGroup PAC ID 8628241544, 13 clinicians

Practice addresses (Care Compare)

5027 Pecan Grove Blvd
San Antonio, TX 78222-3529
Phone (210) 333-6815

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1090339TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychcare of San Antonio I, PLLC Psychiatric/Mental Health CurrentSince Oct 31, 2022 Accepting new patients

Locations

1700 Onion Creek Pkwy
Austin, TX 78748
Phone (512) 291-4900

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

5027 Pecan Grove Blvd
San Antonio, TX 78222
Phone (210) 333-6815

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1558080549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410 STE 220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410 STE 220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165844",
            "telephone_number": "210-888-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALLA",
        "first_name": "SIMMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1090339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.