Individual provider Active NPI

Mitra Shayegh

  • Family Nurse Practitioner
  • Plano, TX
National Provider Identifier
1689371080
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1088926 Issued in TX
Practice address
6537 Preston Rd
Plano, TX 75024-2610
Phone
(972) 867-9131
NPI assigned
Feb 15, 2023
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1088926 TX Primary

Addresses

Primary practice location

6537 Preston Rd
Plano, TX 75024-2610

Mailing address

1763 Montgomery Dr
Plano, TX 75075-1226
Phone (626) 261-2716

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
I20260121001616 TX Practitioner - Nurse Practitioner 0547747503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 E Ogden Ave
Suite 105 313
Naperville, IL 60563-3103

6537 Preston Rd
Plano, TX 75024-2610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1088926TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Doctors, PA CurrentSince Oct 19, 2025 Accepting new patients

Locations

2636 Tibbets Dr
Ste 110
Bedford, TX 76022
Phone (817) 585-0065

2300 Marie Curie Dr
Garland, TX 75042
Phone (972) 487-5000

6537 Preston Rd
Plano, TX 75024
Phone (972) 484-7700

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1689371080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 MONTGOMERY DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750751226",
            "telephone_number": "626-261-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6537 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242610",
            "telephone_number": "972-867-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYEGH",
        "first_name": "MITRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1088926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.