Individual provider Active NPI

Bimisa Chata Augustin, DNP, MSN, APRN,FNP-C

  • Family Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1043765431
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131920 Issued in TX
Practice address
2719 S El Camino Real
San Clemente, CA 92672-3354
Phone
(737) 377-1600
Fax
(949) 569-1295
NPI assigned
Aug 16, 2016
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 72601 NM
Family Nurse Practitioner 363LF0000X 854621 NC
Family Nurse Practitioner 363LF0000X 4015467 KY
Family Nurse Practitioner 363LF0000X 34323 TN
Family Nurse Practitioner 363LF0000X C-APN.0002449-C-NP CO
Family Nurse Practitioner 363LF0000X APRN.CNP.0032880 OH
Family Nurse Practitioner 363LF0000X 267933 AZ
Family Nurse Practitioner 363LF0000X 95028143 CA
Family Nurse Practitioner 363LF0000X APRN11025601 FL
Family Nurse Practitioner 363LF0000X MA7445643 NV
Family Nurse Practitioner 363LF0000X 4704418733 MI
Family Nurse Practitioner 363LF0000X 112050-23 NH
Family Nurse Practitioner 363LF0000X CNP241343 ME
Family Nurse Practitioner 363LF0000X AP131920 TX Primary
Family Nurse Practitioner 363LF0000X 208982 OK

Addresses

Primary practice location

2719 S El Camino Real
San Clemente, CA 92672-3354

Mailing address

3604 Dodge City Dr
Killeen, TX 76549-5728
Phone (949) 484-9517

Other practice location 1

2025 Memory Ln Ste 300
Harker Heights, TX 76548-7488
Phone (949) 484-9517

Other practice location 2

701 N Green Valley Pkwy Ste 213
Henderson, NV 89074-6177
Phone (949) 484-9517

Other practice location 3

3000 N Litchfield Rd Ste 120
Goodyear, AZ 85395-7802
Phone (949) 484-9517

Other practice location 4

1840 Pyramid Pl Ste 237
Memphis, TN 38132-1703
Phone (949) 484-9517

Other practice location 5

128 Chestnut St Ste 303A2
Philadelphia, PA 19106-3024
Phone (949) 484-9517

Other practice location 6

10 N High St Ste 222
Columbus, OH 43215-3497
Phone (949) 484-9517

Other practice location 7

3500 Comanche NW Building E, Ste #15a
Albuquerque, NM 87107-4546
Phone (949) 484-9517

Other practice location 8

20 Foundry St Ste 229
Concord, NH 03301-5419
Phone (949) 484-9517

Other practice location 9

2116 Broadwater Ave Ste 211
Billings, MT 59102-4764
Phone (949) 484-9517

Other practice location 10

400 Renaissance Ctr Ste 2626
Detroit, MI 48243-1502
Phone (949) 484-9517

Other practice location 11

7261 S Broadway Ste 14L
Littleton, CO 80122-8019
Phone (949) 484-9517

Other practice location 12

3499 Blazer Pkwy Ste 325
Lexington, KY 40509-2798
Phone (949) 484-9517

Other practice location 13

41 Hutchins Dr Building 3 UL-12
Portland, ME 04102-1931
Phone (949) 484-9517

Other names 1

  • Mrs. Bimisa Chata Renteria Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO, AZ, NV, CA, NM, NH, KY, MI, TN10 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 10

Enrollment IDStateProvider typePAC IDDetails
I20161117001433 TX Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 3 organizations
I20230928002088 CO Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20231002002052 AZ Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20231102001675 NV Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20231220000932 CA Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20240425002089 NM Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20241022002593 NH Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20241028003065 KY Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20250102001846 MI Practitioner - Nurse Practitioner 1456630383 Reassigns benefits to 1 organization
I20250115003450 TN Practitioner - Nurse Practitioner 1456630383 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
Telehealth
Offers telehealth services
Group practices
Jonathan Larson MD PCGroup PAC ID 8224491501, 3 clinicians
Central Texas Holistic Care PLLCGroup PAC ID 3476081860, 2 clinicians

Practice addresses (Care Compare)

1840 Pyramid Place
Suite 237
Memphis, TN 38132-1703
Phone (949) 484-9517

20 Foundry St
Suite 229
Concord, NH 03301-5419
Phone (949) 484-9517

2025 Memory LN
Suite 300
Harker Heights, TX 76548-7488
Phone (254) 987-8802

2719 S El Camino Real
San Clemente, CA 92672-3354
Phone (949) 484-9517

3000 N Litchfield Rd
Suite 120
Goodyear, AZ 85395-7802
Phone (949) 484-9517

3499 Blazer Pkwy
Suite 325
Lexington, KY 40509-2798
Phone (949) 484-9517

3500 Comanche NW
Building E Suite 15a
Albuquerque, NM 87107
Phone (949) 484-9517

400 Renaissance Ctr
Suite 2626
Detroit, MI 48243-1502
Phone (949) 484-9517

7261 S Broadway
Suite 14L
Littleton, CO 80122-8019
Phone (949) 484-9517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-APN.0002449-C-NPCOMDFamily Nurse Practitioner
APRN11025601FLMDFamily Nurse Practitioner
4015467KYMDFamily Nurse Practitioner
CNP241343MEMDFamily Nurse Practitioner
4704418733MIMDFamily Nurse Practitioner
854621NCMDFamily Nurse Practitioner
MA7445643NVMDFamily Nurse Practitioner
APRN.CNP.0032880OHMDFamily Nurse Practitioner
208982OKMDFamily Nurse Practitioner
34323TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Larson MD PC CurrentSince Aug 15, 2023 Accepting new patients
Central Texas Holistic Care PLLC Family CurrentSince Jan 2, 2025 Accepting new patients
LHP Texas MD Services Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

3000 N Litchfield Rd
Ste 120
Goodyear, AZ 85395
Phone (623) 282-4078

7261 S Broadway
Ste 14L
Littleton, CO 80122
Phone (719) 349-0557

3499 Blazer Pkwy
Ste 325
Lexington, KY 40509

41 Hutchins Dr
Bldg 3
Portland, ME 04102
Phone (612) 999-5829

400 Renaissance Ctr
Ste 2626
Detroit, MI 48243

2116 Broadwater Ave
Ste 211
Billings, MT 59102

20 Foundry St
Ste 229
Concord, NH 03301

3500 Comanche Rd NE
Ste 15A
Albuquerque, NM 87107

2505 Anthem Village Dr
Henderson, NV 89052

2505 Anthem Village Dr
Ste E
Henderson, NV 89052

2505 Anthem Village Dr
Ste E162
Henderson, NV 89052

2505 Anthem Village Dr
Ste F
Henderson, NV 89052

2505 Anthem Village Dr
Ste F162
Henderson, NV 89052

701 N Green Valley Pkwy
Ste 213
Henderson, NV 89074

10 N High St
Ste 222
Columbus, OH 43215

128 Chestnut St
Ste 303
Philadelphia, PA 19106
Phone (215) 399-4128

1840 Pyramid Pl
Memphis, TN 38132
Phone (662) 687-1536

1840 Pyramid Pl
Ste 237
Memphis, TN 38132

201 S Lakeline Blvd
Ste 402
Cedar Park, TX 78613
Phone (512) 593-8443

2025 Memory Ln
Ste 300
Harker Heights, TX 76548
Phone (254) 987-8802

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

800 W Central Texas Expy
Ste 125
Harker Heights, TX 76548
Phone (254) 618-1020

Interoperability endpoints

  • Direct secure messaging: bimisa.augustin.1@27185.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1043765431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 DODGE CITY DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495728",
            "telephone_number": "949-484-9517",
            "fax_number": "361-371-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 S EL CAMINO REAL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723354",
            "telephone_number": "737-377-1600",
            "fax_number": "949-569-1295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Memory Ln Ste 300",
            "address_purpose": "LOCATION",
            "city": "Harker Heights",
            "state": "TX",
            "postal_code": "765487488",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Green Valley Pkwy Ste 213",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890746177",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 N Litchfield Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853957802",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Pyramid Pl Ste 237",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381321703",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Chestnut St Ste 303A2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191063024",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 N High St Ste 222",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432153497",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3500 Comanche NW Building E, Ste #15a",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871074546",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Foundry St Ste 229",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033015419",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Broadwater Ave Ste 211",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591024764",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Renaissance Ctr Ste 2626",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482431502",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7261 S Broadway Ste 14L",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801228019",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3499 Blazer Pkwy Ste 325",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092798",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Hutchins Dr Building 3 UL-12",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041021931",
            "country_code": "US",
            "telephone_number": "949-484-9517",
            "fax_number": "949-569-1295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUGUSTIN",
        "first_name": "BIMISA",
        "middle_name": "CHATA",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, APRN,FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "72601",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "854621",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4015467",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34323",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0002449-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0032880",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "267933",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028143",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025601",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "MA7445643",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704418733",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "112050-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241343",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131920",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "208982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BIMISA",
            "last_name": "RENTERIA",
            "middle_name": "CHATA",
            "prefix": "MRS.",
            "credential": "MSN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.