Individual provider Active NPI

Lloyd Ehigie Esene, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1013542158
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP145774 Issued in TX
Practice address
5900 Balcones Dr # 8229
Austin, TX 78731-4257
Phone
(469) 407-1172
Fax
(682) 222-7024
NPI assigned
Mar 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP145774 TX Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 800894 TX

Addresses

Primary practice location

5900 Balcones Dr # 8229
Austin, TX 78731-4257

Mailing address

2012 Hickory Hill Dr
Mansfield, TX 76063-2069
Phone (469) 407-1172

Other practice location 1

1501 S Coulter St
Amarillo, TX 79106-1770
Phone (214) 622-8556

Other identifiers 1

IdentifierTypeStateIssuer
1B1722OtherTXMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebonyman06@sbcglobal.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WV, CO, NY, DC, VA, UT, NE8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20210910002393 AZ Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization
I20230720000956 WV Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization
I20241024004501 CO Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization
I20241113003241 NY Practitioner - Nurse Practitioner 7911337910
I20241206003345 DC Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization
I20250107003099 VA Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization
I20250220003335 UT Practitioner - Nurse Practitioner 7911337910 Practice locations: Draper, UT
I20250331000283 NE Practitioner - Nurse Practitioner 7911337910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1201 O St
Suite 809
Lincoln, NE 68508-1420
Phone (469) 407-1172

2102 Hickory Hill Dr
Mansfield, TX 76063-2069

4101 Old Ivy Way
Charlottesville, VA 22901
Phone (469) 407-1172

4309 John St
Suitland, MD 20746-3716
Phone (469) 407-1172

4419 Centennial Blvd
Suite 551
Colorado Springs, CO 80907-3739
Phone (469) 407-1172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP145774TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Telecare Medical Services PC CurrentSince Jun 21, 2023 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Sep 15, 2021 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

14541 Delano St
Van Nuys, CA 91411
Phone (310) 515-8113

128 Capitol St
Charleston, WV 25301
Phone (276) 979-5390

Organizations & group practices 3

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1013542158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HICKORY HILL DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632069",
            "telephone_number": "469-407-1172",
            "fax_number": "682-222-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR # 8229",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "469-407-1172",
            "fax_number": "682-222-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061770",
            "country_code": "US",
            "telephone_number": "214-622-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESENE",
        "first_name": "LLOYD",
        "middle_name": "EHIGIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145774",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "800894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1B1722",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebonyman06@sbcglobal.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1501 S Coulter St",
            "city": "Amarillo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "791061770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.