Hisayo Hara Pelton, CNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1144651 Issued in TX

Practice address

8418 Lullwater Dr
Dallas, TX 75218-1150

Phone

(214) 503-0590

NPI assigned

Sep 2, 2024

Last updated

Mar 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Medical Center - MaryvilleGroup PAC ID 3678813896, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mosaic Medical Center - Maryville Hospital, Maryville, MO, CCN 261340
• Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

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.

• Mosaic Medical Center - Maryville

  • Specialist
  • Maryville, MO
  • NPI 1184189797
  Medicare reassignment Care Compare group
• Heartland Regional Medical Center

  dba Mosaic Life Care

  • General Practice Physician
  • Saint Joseph, MO
  • NPI 1477575405
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Heartland Regional Medical Center

  dba Mosaic Life Care at St Joseph Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  Care Compare affiliation
• Mosaic Medical Center - Maryville

  • Critical Access Hospital
  • Maryville, MO
  • NPI 1265906663
  Care Compare affiliation

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1649004557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8418 LULLWATER DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752181150",
            "telephone_number": "214-732-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8418 LULLWATER DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752181150",
            "telephone_number": "214-503-0590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2016 S Main St",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "MO",
            "postal_code": "644682655",
            "country_code": "US",
            "telephone_number": "660-562-7039",
            "fax_number": "660-562-7994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELTON",
        "first_name": "HISAYO",
        "middle_name": "HARA",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026003045",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1144651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pella Medical Supply Inc
• Shelby L Pelleran, CAA
• Shayla Pellerin
• Lydia Laurel Pellikan, MDIV
• Peloza Surgical Services, PLLC (Center for Spine Care)
• Matthias Peltz, MD
• Pelvic Specialty Surgery Suites LLC
• Jennifer Katheryn Pemberton, RN, FNP
• Helene Nicolle Pena Sahdala, MD
• Melissa Pena Vidal, CRNA

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.