Individual provider Active NPI

Karissa Monique Nauert, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1962753491
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37762 Issued in TX
Practice address
8000 W Interstate 10 Ste 626
San Antonio, TX 78230-3868
Phone
(210) 900-0252
Fax
(210) 703-9155
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X 37762 TX
Clinical Psychologist 103TC0700X 37762 TX Primary

Addresses

Primary practice location

8000 W Interstate 10 Ste 626
San Antonio, TX 78230-3868

Mailing address

8000 W Interstate 10 Ste 626
San Antonio, TX 78230-3868
Phone (210) 900-0252

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
I20171220001585 TX Practitioner - Clinical Psychologist 1052679016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8000 W Interstate 10
Suite 626
San Antonio, TX 78230-3868
Phone (210) 900-0252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37762TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vine Behavioral Health and Wellness, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 15, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 15, 2022 Accepting new patients

Locations

11130 Christus Hls
Fl 3
San Antonio, TX 78251
Phone (210) 703-9001

8000 W Interstate 10
Ste 626
San Antonio, TX 78230
Phone (210) 900-0252

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Organizations & group practices 3

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": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1962753491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 W INTERSTATE 10 STE 626",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303868",
            "telephone_number": "210-900-0252",
            "fax_number": "210-703-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 W INTERSTATE 10 STE 626",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303868",
            "telephone_number": "210-900-0252",
            "fax_number": "210-703-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUERT",
        "first_name": "KARISSA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37762",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.