MAYRA ELIZONDO FNP-C
NPI 1073120762
Nurse Practitioner in Tyler, TX

Q: What is Mayra Elizondo's NPI number?

The NPI number for Mayra Elizondo is 1073120762. It was assigned to this individual provider in the NPPES registry on September 26, 2020.

Q: What is Mayra Elizondo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mayra Elizondo was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 26, 2020PECOS EnrolledAccepts Medicare Assignment

1133 MEDICAL DR, TYLER, TX 75701(903) 595-5486(903) 595-5128 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 4, 2023, Nov 14, 2022, Sep 26, 2020 (3 updates tracked since 2020).

On this page

About Mayra Elizondo Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAYRA ELIZONDO FNP-C (NPI 1073120762) is an individual nurse practitioner in Tyler, Texas, licensed in Texas (AP1097801) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and maintains a secondary practice location in Tyler.

NPPES Registry Identity

NPI1073120762

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMAYRA ELIZONDOCredential: FNP-C

Location Address1133 MEDICAL DRTyler, TX 75701-2130

Mailing Address1133 Medical DrTyler, TX 75701-2130 · (903) 595-5486 · Fax (903) 595-5128

Phone(903) 595-5486

Fax(903) 595-5128

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateSeptember 26, 2020

Last NPPES UpdateFebruary 23, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2026

✔ NPI 1073120762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TX · AP1097801

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 944960 (TX)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License AP1097801 (TX)

1133 MEDICAL DR, Tyler, TX 75701

Open in Google Maps ↗

Secondary Practice Location 1

Location 1910 E Houston St Ste 330Tyler, TX 75702-8368 · Phone (903) 606-7995

Other Identifiers 1

Other944960TX · Rn

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mayra Elizondo Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42689192

PECOS Enrollment IDI20221212001468

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

114 services103 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

37 services37 patients

Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour G0420

This service involves one-on-one educational sessions about managing chronic kidney disease. Each session lasts about an hour. Topics can include understanding the disease, dietary changes, medication management, and lifestyle modifications to help control the condition.

21 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX

1/5 CMS rating

OwnershipProprietary

CMS Certification Number450083

Location1000 South Beckham AveTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450102

Location800 East DawsonTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IFEATU UCHENNA OTI MD

Internal Medicine (Nephrology)