Individual provider Active NPI

Amy Rose Mulroy, MD

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1669564902
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J6417 Issued in TX
Practice address
11124 Wurzbach, Ste 305
San Antonio, TX 78230
Phone
(210) 692-1929
Fax
(210) 692-1904
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J6417 TX Primary
Addiction Psychiatry Physician 2084P0802X J6417 TX

Addresses

Primary practice location

11124 Wurzbach, Ste 305
San Antonio, TX 78230

Mailing address

11124 Wurzbach, Ste. 305
San Antonio, TX 78230
Phone (210) 692-1929

Other identifiers 1

IdentifierTypeStateIssuer
0409385MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J6417TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Mulroy M.D. PA Psychiatry Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1669564902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 WURZBACH, STE. 305",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78230",
            "telephone_number": "210-692-1929",
            "fax_number": "210-692-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 WURZBACH, STE 305",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78230",
            "telephone_number": "210-692-1929",
            "fax_number": "210-692-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULROY",
        "first_name": "AMY",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J6417",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TX",
            "license": "J6417",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409385",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.