Individual provider Active NPI

Modesta Obiageli Onyia, FNP

  • Family Nurse Practitioner
  • Georgetown, TX
National Provider Identifier
1013340520
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
679518 Issued in TX
Practice address
205 E University Ave
Suite 157
Georgetown, TX 78626-6814
Phone
(512) 868-9078
Fax
(512) 819-0646
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 679518 TX Primary

Addresses

Primary practice location

205 E University Ave
Suite 157
Georgetown, TX 78626-6814

Mailing address

1913 Mesa CT
Garland, TX 75040-8289
Phone (214) 629-9639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241125002768 NY Practitioner - Nurse Practitioner 7416986914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timely Psychiatry and Family Health NP PracticeGroup PAC ID 8628433414, 6 clinicians

Practice addresses (Care Compare)

230 Hilton Ave
Suite 15
Hempstead, NY 11550-8116
Phone (516) 854-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Timely Psychiatry and Family Health NP Practice CurrentSince Sep 20, 2024 Accepting new patients
Jenmerit Home Health Inc PastSince Apr 8, 2019 Accepting new patients

Locations

230 Hilton Ave
Ste 103
Hempstead, NY 11550
Phone (516) 464-0266

230 Hilton Ave
Ste 15
Hempstead, NY 11550
Phone (516) 464-0266

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jenmerit Home Health IncGarland, TX, CCN 677831 Home health agency 5% Or Greater Direct Ownership Interest
Corporate Officer
Corporate Director
W-2 Managing Employee
Dec 20, 2004
Dec 20, 2004
Aug 4, 2005
Dec 20, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1013340520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 MESA CT",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750408289",
            "telephone_number": "214-629-9639",
            "fax_number": "972-278-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE",
            "address_2": "SUITE 157",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266814",
            "telephone_number": "512-868-9078",
            "fax_number": "512-819-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYIA",
        "first_name": "MODESTA",
        "middle_name": "OBIAGELI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "679518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.