NPIMap

Organization Active NPI

Texas Advance Behavioral Health

  • Psychiatry Physician
  • Arlington, TX
National Provider Identifier
1730567462
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
748914 Issued in TX
Legal business name
TEXAS ADVANCE BEHAVIORAL HEALTH
Practice address
715 N Fielder Rd
Arlington, TX 76012-4695
Phone
(682) 220-9615
Fax
(817) 200-6813
NPI assigned
May 14, 2015
Organization subpart
Yes
Parent organization
TEXAS ADVANCE BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Maria Mosomi, PMHNP-BCNPI 1932440021
Title
Nurse Practitioner
Phone
(682) 220-9615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 748914 TX Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

715 N Fielder Rd
Arlington, TX 76012-4695

Mailing address

715 N Fielder Rd
Arlington, TX 76012-4695
Phone (682) 220-9615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151027000331 TX Part B Supplier - Clinic/Group Practice 5991014391 Receives reassigned benefits from 8 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory
Part of
TX Advance Behavioral HLTH

Locations

715 N Fielder Rd
#B
Arlington, TX 76012
Phone (682) 220-9615

715 N Fielder Rd
Ste B
Arlington, TX 76012
Phone (682) 220-9615

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1730567462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "682-220-9615",
            "fax_number": "817-200-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "682-220-9615",
            "fax_number": "817-200-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS ADVANCE BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS ADVANCE BEHAVIORAL HEALTH",
        "enumeration_date": "2015-05-14",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "MOSOMI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "682-220-9615",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "748914",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.