Individual provider Active NPI

Sandra Adanma Nwanganga-Anusiem, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Addison, TX
National Provider Identifier
1104135235
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1155522 Issued in TX
Practice address
15080 E Beltwood Pkwy Ste 108
Addison, TX 75001-3725
Phone
(201) 281-7122
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 505482 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1155522 TX Primary

Addresses

Primary practice location

15080 E Beltwood Pkwy Ste 108
Addison, TX 75001-3725

Mailing address

15080 E Beltwood Pkwy Ste 108
Addison, TX 75001-3725
Phone (201) 281-7122

Other practice location 1

6950 Shady Ln
Scurry, TX 75158-2831
Phone (972) 452-2210 ext. 4054

Other names 1

  • Sandra Nwanganga Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20241031003290 TX Practitioner - Nurse Practitioner 0345773115 Reassigns benefits to 6 organizations
I20251013003266 NY Practitioner - Nurse Practitioner 0345773115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

706 Ferry St
East Dublin, GA 31027-7450

820 Goose CT
Forney, TX 75126-7498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
505482NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Texana Center CurrentSince Sep 23, 2024 Accepting new patients
Border Region MH Mr Community Center CurrentSince Feb 10, 2025 Accepting new patients
My Health My Resources of Tarrant County CurrentSince Feb 24, 2025 Accepting new patients
Heart of Texas Region MHMR Center CurrentSince Aug 22, 2024 Accepting new patients
Sancharles Behavioral Healthcare Services LLC Psychiatric/Mental Health CurrentSince Aug 4, 2025 Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Nov 9, 2024 Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Nov 9, 2024 Accepting new patients
Burke Center CurrentSince Nov 1, 2024 Accepting new patients
Burke Center PastSince Nov 1, 2024 Accepting new patients

Locations

548 Throggs Neck Expy
Ste 4
Bronx, NY 10465
Phone (201) 281-7122

15080 E Beltwood Pkwy
Ste 108
Addison, TX 75001
Phone (201) 281-7122

3840 Hulen St
Ft Worth, TX 76107
Phone (817) 569-4395

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

601 N Frio St
#1
San Antonio, TX 78207
Phone (210) 225-5481

6800 Park Ten Blvd
Ste 200S
San Antonio, TX 78213
Phone 21026110001060

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

Organizations & group practices 9

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1104135235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15080 E BELTWOOD PKWY STE 108",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013725",
            "telephone_number": "201-281-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15080 E BELTWOOD PKWY STE 108",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013725",
            "telephone_number": "201-281-7122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6950 Shady Ln",
            "address_purpose": "LOCATION",
            "city": "Scurry",
            "state": "TX",
            "postal_code": "751582831",
            "country_code": "US",
            "telephone_number": "972-452-2210 x4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWANGANGA-ANUSIEM",
        "first_name": "SANDRA",
        "middle_name": "ADANMA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "505482",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1155522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "NWANGANGA",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.