DR. NISHAD MYSORE DO
NPI 1649023631
Student in an Organized Health Care Education/Training Program in San Antonio, TX

Active since April 09, 2024PECOS Enrolled
4499 MEDICAL DR STE 171, SAN ANTONIO, TX 78229(346) 550-6457 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Nishad Mysore Do NPPES

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

DR. NISHAD MYSORE DO (NPI 1649023631) is an individual student in an organized health care education/training program in San Antonio, Texas and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649023631
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. NISHAD MYSORECredential: DO
Location Address4499 MEDICAL DR STE 171San Antonio, TX 78229-3789
Mailing Address4499 Medical Dr Ste 171San Antonio, TX 78229-3789
Sole ProprietorYes
Enumeration DateApril 9, 2024
NPPES CertifiedApril 9, 2024
NPI 1649023631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4499 MEDICAL DR STE 171, San Antonio, TX 78229

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Nishad Mysore Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229
Student in an Organized Health Care Education/Training Program
4499 MEDICAL DR STE 171
SAN ANTONIO, TX 78229

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649023631, enumerated as an "individual" on April 09, 2024.

The provider is located at 4499 MEDICAL DR STE 171 SAN ANTONIO, TX 78229 and the phone number is (346) 550-6457.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.