NPIMap

Organization Active NPI

Mypsych Mental Health, PLLC

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1871962191
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MYPSYCH MENTAL HEALTH, PLLC
Practice address
8026 Floyd Curl Dr
San Antonio, TX 78229
Phone
(210) 990-1142
NPI assigned
Sep 16, 2015
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Dr. Mikael James Jacobson, MDNPI 1356364384
Title
Medical Doctor
Phone
(210) 363-5471

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 Physician 2084P0800X L5386 TX
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

8026 Floyd Curl Dr
San Antonio, TX 78229

Mailing address

8407 Bandera Road Ste 103
Box 103448
San Antonio, TX 78250
Phone (210) 990-1142

Other identifiers 1

IdentifierTypeStateIssuer
164124306MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170213002322 TX Part B Supplier - Clinic/Group Practice 5890078042 Receives reassigned benefits from 23 practitioners
Practice locations: Boerne, TX; San Antonio, TX

National Provider Directory

National Provider Directory

Locations

8111 Mainland Dr
#104448
San Antonio, TX 78240

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1871962191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8407 BANDERA ROAD STE 103",
            "address_2": "BOX 103448",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78250",
            "telephone_number": "210-990-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8026 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-990-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYPSYCH MENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "MIKAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "210-363-5471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L5386",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164124306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.