Individual provider Active NPI

Miyori T Pullen

  • Clinical Social Worker
  • Arlington, TX
National Provider Identifier
1831813781
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
63185 Issued in TX
Practice address
6803 Ijaz Dr
Arlington, TX 76017-4977
Phone
(254) 652-0304
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 63185 TX
Clinical Social Worker 1041C0700X 63185 TX Primary

Addresses

Primary practice location

6803 Ijaz Dr
Arlington, TX 76017-4977

Mailing address

6803 Ijaz Dr
Arlington, TX 76017-4977
Phone (254) 652-0304

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014001512 TX Practitioner - Clinical Social Worker 0143696278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Oct 18, 2022 Accepting new patients
Pull-Up a Veterans Home CurrentSince Sep 5, 2023 Accepting new patients
Assurasource LTD Clinical CurrentSince Oct 1, 2022 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients

Locations

100 Allentown Pkwy
Ste 206
Allen, TX 75002

400 N Allen Dr
Ste 204
Allen, TX 75013

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1831813781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6803 IJAZ DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174977",
            "telephone_number": "254-652-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6803 IJAZ DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174977",
            "telephone_number": "254-652-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "MIYORI",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "63185",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.