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MEDI- ELITE, PC
NPI 1528330792
Clinic/Center - Primary Care in Bedford, TX

Active since February 03, 2012CLIA 45D2322147 · Waiver
2721 CENTRAL DR, BEDFORD, TX 76021(682) 703-8881(706) 203-3259 Get Directions Write a Review

NPPES record last updated: November 24, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 24, 2024, Sep 28, 2020 (2 updates tracked since 2020).

About Medi- Elite, Pc NPPES

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

MEDI- ELITE, PC (NPI 1528330792) is a healthcare organization registered as a primary care in Bedford, Texas and active in the NPI registry since February 2012. The organization holds a CLIA Waiver certificate valid through April 15, 2027 and lists Mahalia L Jackson-butler, Ceo, as its authorized official.

NPPES Registry Identity

NPI1528330792
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMEDI- ELITE, PC
Location Address2721 CENTRAL DRBedford, TX 76021-4810
Mailing Address4621 S Cooper St Ste 131-717Arlington, TX 76017-5866 · (214) 277-2243 · Fax (214) 231-2926
Phone(682) 703-8881
Fax(706) 203-3259
Organization SubpartNo
Authorized OfficialMahalia L Jackson-butlerCeo · (214) 277-2243
Enumeration DateFebruary 3, 2012
Last NPPES UpdateNovember 24, 20242 updates tracked since enumeration
NPPES CertifiedNovember 24, 2024
✔ NPI 1528330792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedCustodial Care Facility · Adult Care HomeTaxonomy 311ZA0620X · License AP117597 (TX)
Also ListedSkilled Nursing FacilityTaxonomy 314000000X · License AP117597 (TX)
Also ListedNurse PractitionerTaxonomy 363L00000X · License AP117597 (TX)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License AP117597 (TX)
Also ListedNurse Practitioner · Community HealthTaxonomy 363LC1500X · License AP117597 (TX)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License AP117597 (TX)
2721 CENTRAL DR, Bedford, TX 76021
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Medi- Elite, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Medi- Elite, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Mahalia Jackson Butler, DNP, APRN
Nurse Practitioner
NPI 1063669893
2721 CENTRAL DR
Bedford, TX 76021
(214) 277-2243
✔ PECOS✔ Accepts MedicareSame address
Mariel Yumul, FNP
Nurse Practitioner
NPI 1780555201
2721 CENTRAL DR
Bedford, TX 76021
(682) 703-8881
✔ PECOS✔ Accepts MedicareSame address
Shelley Reed-Pouncy, APRN-CNP
Nurse Practitioner
NPI 1588470272
2817 STARK ST STE D
Fort Worth, TX 76112
(817) 451-6413
✔ PECOS9.6 mi
Peris Momanyi
Nurse Practitioner
NPI 1194533356
3531 PONDEROSA DR
Grand Prairie, TX 75052
(469) 358-9331
✔ PECOS✔ Accepts Medicare13 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2322147

Medi-Elite Health And Wellness · Bedford, TX
Active · expires Apr 15, 2027
CLIA Number45D2322147
Laboratory TypePractitioner Other
Certificate Effective DateApril 16, 2025
Certificate Expiration DateApril 15, 2027
Laboratory DirectorMahalia L. Jackson-Butler
Laboratory Phone(682) 703-8881
Laboratory LocationMedi-Elite Health And Wellness2721 Central Drive, Bedford, TX 76021
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medi- Elite, PC's NPI number?

The NPI number for Medi- Elite, PC is 1528330792. It was assigned to this organization in the NPPES registry on February 3, 2012.

Where is Medi- Elite, PC located?

Medi- Elite, PC is located at 2721 Central Dr, Bedford, TX 76021. The listed phone number is (682) 703-8881.

What is Medi- Elite, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Medi- Elite, PC enrolled in Medicare?

Yes. Medi- Elite, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Medi- Elite, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Medi- Elite, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Medi- Elite, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2322147) is associated with this NPI, valid through April 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Medi- Elite, PC accept?

Health plans from Blue Cross and Blue Shield of Texas list Medi- Elite, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Medi- Elite, PC was last updated on November 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.