Individual provider Active NPI

Matthew Schulke, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kyle, TX
National Provider Identifier
1861908576
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1175658 Issued in TX
Practice address
1300 Dacy LN Ste 120-130
Kyle, TX 78640-4192
Phone
(512) 392-8953
Fax
(512) 262-7505
NPI assigned
Dec 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 899253 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1175658 TX Primary

Addresses

Primary practice location

1300 Dacy LN Ste 120-130
Kyle, TX 78640-4192

Mailing address

819 Water St
Kerrville, TX 78028-5333
Phone (830) 792-7505

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
I20241014002097 TX Practitioner - Nurse Practitioner 2961934112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hill Country Community MHMR CenterGroup PAC ID 3072599752, 28 clinicians

Practice addresses (Care Compare)

1300 Dacy LN
Suite 120
Kyle, TX 78640-4194
Phone (844) 327-1274

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
899253TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Community MHMR Center CurrentSince Sep 24, 2024 Accepting new patients

Locations

819 Water St
Ste 300
Kerrville, TX 78028
Phone (830) 258-5430

1300 Dacy Ln
Ste 120
Kyle, TX 78640
Phone (512) 392-8953

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1861908576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WATER ST",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285333",
            "telephone_number": "830-792-7505",
            "fax_number": "830-792-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 DACY LN STE 120-130",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786404192",
            "telephone_number": "512-392-8953",
            "fax_number": "512-262-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULKE",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "899253",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1175658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.