Jennifer Idima

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1110552 Issued in TX

Practice address

2800 S Macgregor Way
Houston, TX 77021-1032

Phone

(914) 308-1217

NPI assigned

Mar 30, 2023

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.11 of 100Reported as group

Quality

69.15

Promoting interoperability

100

Improvement activities

40

Cost

73.63

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821
  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TX

  Medicare reassignment
• Ut Physicians

  dba UT Health Services

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1093410136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S MACGREGOR WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211032",
            "telephone_number": "914-308-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S MACGREGOR WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211032",
            "telephone_number": "914-308-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDIMA",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1110552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melina Laureanne Idi
• Idic Healthcare, PLLC
• Amie Idicula, LPC, M.A.
• Anishya Jose Idicula, PA
• Sindhu Idicula, MD
• Monday Bassey Idiong, MANAGER
• Idjagboro Healthcare and Medical Services Inc
• Damian Okpako Idjagboro, PA-C
• Idoc Telehealth Solutions, Inc
• Idoc Virtual Telehealth Texas

• Psychiatric/Mental Health Nurse Practitioner in Houston, TX
• Providers in Houston, 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 Mar 30, 2023; 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.