Fredrick Odongo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1051796 Issued in TX

Practice address

715 N Fielder Rd
Arlington, TX 76012-4695

Phone

(817) 962-0409

NPI assigned

Nov 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ipc Pac Healthcare Services of Texas PLLCGroup PAC ID 1759676307, 42 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.72 of 100Reported as apm

Quality

72.97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Ipc Pac Healthcare Services of Texas PLLC

  • Hospitalist Physician
  • Addison, TX
  • NPI 1194174201

  TX

  Medicare reassignment Care Compare group NPD
• CS Pacs 3 Southwest, LLC

  • Hospitalist Physician
  • Baytown, TX
  • NPI 1275398430

  TX

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1104582006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8206 ITHACA DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760024423",
            "telephone_number": "817-412-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "817-962-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONGO",
        "first_name": "FREDRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1051796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "endpointDescription": "Texas Behavioral Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "715 N Fielder Rd",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760124695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Occupational Health Centers of the Southwest, P.a.
• Oceanside International Inc
• Ruth Oday
• Adetunji A Odeyemi
• Fidel Oneal Odom
• Tioluwani Odukoya
• Cordelia Odunayo, NP
• Julieann Ofodile, PHARMD
• Donald Ofoh
• Oluwatunmike Ogedengbe

• All providers in Arlington, TX
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.