Individual provider Active NPI

Elizabeth Macshadiya, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fulshear, TX
National Provider Identifier
1992257828
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP132375 Issued in TX
Practice address
5757 Flewellen Oaks LN Ste 302
Fulshear, TX 77441-1801
Phone
(713) 987-7828
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP132375 TX Primary

Addresses

Primary practice location

5757 Flewellen Oaks LN Ste 302
Fulshear, TX 77441-1801

Mailing address

24285 Katy Fwy Ste 300
Katy, TX 77494-1128

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
I20181008000717 TX Practitioner - Nurse Practitioner 9739431495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mosaic Mental HealthGroup PAC ID 1254732043, 3 clinicians

Practice addresses (Care Compare)

5757 Flewellen Oaks LN
Suite 302
Fulshear, TX 77441-1801
Phone (713) 987-7828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132375TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Mental Health Psychiatric/Mental Health CurrentSince Jun 1, 2021 Accepting new patients
Redoak Psychiatry Psychiatric/Mental Health Past Accepting new patients
Red Oak Psychiatry Associates, P.a. PastSince Apr 10, 1991 Accepting new patients

Locations

7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420

5757 Flewellen Oaks Ln
Ste 302
Fulshear, TX 77441
Phone (713) 987-7828

25807 Westheimer Pkwy
Ste 327
Katy, TX 77494
Phone (713) 987-7828

25807 Westheimer Pkwy
Ste 436
Katy, TX 77494

24285 Katy Fwy
Ste 300
Katy, TX 77494
Phone (346) 387-7171

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1992257828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24285 KATY FWY STE 300",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 FLEWELLEN OAKS LN STE 302",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774411801",
            "telephone_number": "713-987-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACSHADIYA",
        "first_name": "ELIZABETH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulshear, TX

Sources for this page

Verify at the official NPI Registry.