Elizabeth Shijo Puthur

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1156012 Issued in TX

Practice address

901 Silver Sage Dr
Wylie, TX 75098-8602

Phone

(469) 867-6011

NPI assigned

Apr 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heal 360 Primary Care PLLCGroup PAC ID 4688972052, 4 clinicians

Moksh Medical Group PLLCGroup PAC ID 8123310414, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Heal 360 Primary Care PLLC

  • General Practice Physician
  • Wylie, TX
  • NPI 1588022800
  Medicare reassignment Care Compare group NPD
• Moksh Medical Group PLLC

  • Infectious Disease Physician
  • Dallas, TX
  • NPI 1588011753
  Medicare reassignment Care Compare group NPD
• Heal 360 Urgent Care, LLC

  • Family Medicine Physician
  • Wylie, TX
  • NPI 1295165967
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hunt Memorial Hospital District

  dba Hunt Regional

  • General Acute Care Hospital
  • Greenville, TX
  • NPI 1598750721
  Care Compare affiliation

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1922851385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SILVER SAGE DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750988602",
            "telephone_number": "469-867-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SILVER SAGE DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750988602",
            "telephone_number": "469-867-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3804 W 15th St",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750754752",
            "country_code": "US",
            "telephone_number": "972-801-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTHUR",
        "first_name": "ELIZABETH",
        "middle_name": "SHIJO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "871213",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1156012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Faith Price, LMSW
• Prime Care Transports LLC
• Primrose Care
• Amanda Prouty, CPM, LM
• Pure View Dianostic
• Maimoona Qamar, M.D
• QCP Wylie LLC (Quality Care Pharmacy)
• Annie Quach, O.D.
• Cassie Quail
• R R Maguire Management Inc (Northeast Rehab)

• Family Nurse Practitioner in Wylie, TX
• Providers in Wylie, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.