Monalisa M Mitra, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M4363 Issued in TX

Practice address

4100 Heritage Ave
Ste 106
Grapevine, TX 76051-5714

Phone

(817) 283-1112

Fax

(817) 283-1116

NPI assigned

Aug 30, 2006

Last updated

Jun 1, 2022By 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 1

Addresses

Other identifiers 2

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of North Texas HSC, College of Osteopathic Med, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Dallas Medical Specialists, PLLCGroup PAC ID 3072895788, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmitra225352@direct.sw.org
• Direct secure messaging: monalisa.mitra@hca7.eclinicaldirectplus.com

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.

• Dallas Medical Specialists, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1508217811
  Medicare reassignment Care Compare group NPD
• Excel Physicians Group PLLC

  • Internal Medicine Physician
  • Grapevine, TX
  • NPI 1558706119
  Medicare reassignment NPD Authorized official
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Inpatient Physician Associates PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1285696898
  Medicare reassignment NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906

  Internal Medicine

  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)
• Lonestar Provider Network

  dba Dallas Medical Specialists

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1194765586
  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814

  Internal Medicine

  NPD (past)
• True Medicine, PA

  • Internal Medicine Physician
  • Trophy Club, TX
  • NPI 1952550352
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1710097456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 HERITAGE AVE STE 106",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515716",
            "telephone_number": "817-283-1112",
            "fax_number": "817-283-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 HERITAGE AVE",
            "address_2": "STE 106",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515714",
            "telephone_number": "817-283-1112",
            "fax_number": "817-283-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 City Point Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761808380",
            "country_code": "US",
            "telephone_number": "817-255-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITRA",
        "first_name": "MONALISA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M4363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184283303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184283302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmitra225352@direct.sw.org",
            "affiliation": "N",
            "address_1": "1650 W College St Ste 150",
            "city": "Grapevine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760513565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leslie Jean Miner, D.C.
• Mint Dentistry, PLLC (Grapevine Mint Dentistry)
• Mint Oral Surgery, PLLC
• Shazia Mirza
• Kelly Mitchell, P.T.
• Caitlyn Hazzard Mixon
• Mobility Care
• Phillipa Ifeoma Modebelu, RN/NP
• Modern Anesthesia Solutions
• Modern Crescent Anesthesia

• Internal Medicine Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.