Individual provider Active NPI

Nestor Arita, MD

  • Vascular Surgery Physician
  • Mountain Home, AR
National Provider Identifier
1124438072
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
E-17695 Issued in AR
Practice address
628 Hospital Dr
Mountain Home, AR 72653-2953
Phone
(508) 320-0708
NPI assigned
Apr 30, 2014
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X BP10050138 TX
Vascular Surgery Physician 2086S0129X 63127 TN
Vascular Surgery Physician 2086S0129X E-17695 AR Primary

Addresses

Primary practice location

628 Hospital Dr
Mountain Home, AR 72653-2953

Mailing address

1 Baylor PLZ
404D
Houston, TX 77030-3411

Other practice location 1

700 W Forest Ave
Jackson, TN 38301-3937
Phone (731) 541-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210726003338 TN Practitioner - Vascular Surgery 4385987619 Reassigns benefits to 1 organization
I20240730004334 AR Practitioner - Thoracic Surgery 4385987619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Baylor College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

628 Hospital Dr
E 1
Mountain Home, AR 72653-2953
Phone (870) 425-3291

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10050138TXMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Aug 2, 2021 Accepting new patients
Baxter County Regional Hospital, Inc CurrentSince Aug 1, 2024 Accepting new patients
Baxter County Regional Hospital Inc CurrentSince Aug 1, 2024 Accepting new patients
Baxter County Regional Hospital Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

624 Hospital Dr
Mountain Home, AR 72653
Phone (870) 424-1000

628 Hospital Dr
Mountain Home, AR 72653
Phone (870) 425-4402

628 Hospital Dr
#E1
Mountain Home, AR 72653
Phone (870) 425-3291

628 Hospital Dr
Ste E1
Mountain Home, AR 72653
Phone (870) 425-3291

1718 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-5121

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Ste 4
Jackson, TN 38301

103A Jane St
Paris, TN 38242

405 Tyson Ave
Paris, TN 38242
Phone (731) 394-3499

270 E Court Ave
#B
Selmer, TN 38375
Phone 73164579322931

Interoperability endpoints

  • Direct secure messaging: nestor.arita@bhcawp.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1124438072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "address_2": "404D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "508-320-0708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013937",
            "country_code": "US",
            "telephone_number": "731-541-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARITA",
        "first_name": "NESTOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "BP10050138",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "63127",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "E-17695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.