Shyam A Vyas, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L4790 Issued in TX

Practice address

3516 NE Stallings Dr
Nacogdoches, TX 75965

Phone

(936) 560-0818

Fax

(936) 560-5610

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Moonrise Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Nacogdoches, TX
  • NPI 1720580053
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1992850184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75965",
            "telephone_number": "936-560-0818",
            "fax_number": "936-560-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75965",
            "telephone_number": "936-560-0818",
            "fax_number": "936-560-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "SHYAM",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L4790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158515001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Verhalen, M.A., LPC ASSOCIATE
• David Vinther, MD
• Randal N Vinther, M.D.
• Vip Hospice, LLC
• Kavita S Vyas, M.D.
• Kalisha Wade, CCC SLP
• Ladedra Wade
• Wagoner Health Clinic, PLLC
• James Lucas Wagoner, MSN, APRN, FNP-C
• Rebekah Marie Wagoner, APRN, FNP-C

• Psychiatry Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.