Rachel Spencer Ivanov, MSN, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1030787 Issued in TX

Practice address

705 Landa St Ste C
New Braunfels, TX 78130-6163

Phone

(210) 360-1590

Fax

(210) 855-9300

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, ME2 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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S Regional Medical Center Hospital, Lewiston, ME, CCN 200034

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rivanov1909361@direct.bsmhealth.org

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.

• St. Mary'S Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584
  Medicare reassignment Care Compare group NPD
• Community Clinical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1164477568
  Medicare reassignment NPD
• Evergreen Mental Health and Wellness LLC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Austin, TX
  • NPI 1295330520
  NPD (past) Authorized official
• Community Clinical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1629851761
  NPD
• Community Clinical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1184702821
  NPD
• St. Mary'S Regional Medical Center

  • Skilled Nursing Facility
  • Lewiston, ME
  • NPI 1952306524
  NPD
• Clark & Gossett Implant and Oral Surgery, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • New Braunfels, TX
  • NPI 1669640876
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584
  Care Compare affiliation

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1053916379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 HALFWAY CV",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786811005",
            "telephone_number": "512-591-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LANDA ST STE C",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306163",
            "telephone_number": "210-360-1590",
            "fax_number": "210-855-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4004 Halfway Cv",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786811005",
            "country_code": "US",
            "telephone_number": "512-591-6841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "RACHEL",
        "middle_name": "SPENCER",
        "credential": "MSN, APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "902941",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1030787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inspired Senior Living of New Braunfels Mt LLC
• Integrative Therapy Specialist
• Intuitive Mind Behavioral Health PLLC
• Irvin Sahni, M.D. PA.
• Karrie Itz-Thompson, R.D., L.D.
• Emily Annmarie Ivey, LPC
• Jackie Engelhardt Counseling PLLC
• Randal K Jacks, MD
• Jackson Savage P.L.L.C.
• Candace McKenzie Jackson, LPC

• Psychiatric/Mental Health Nurse Practitioner in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.