Individual provider Active NPI

Omah S Tsikada, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Forney, TX
National Provider Identifier
1124612684
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP1154144 Issued in TX
Practice address
425 Pinson Rd
Ste M PMB 1027
Forney, TX 75126-9774
Phone
(903) 689-3994
NPI assigned
Feb 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP1154144 TX Primary
Registered Nurse 163W00000X 826532 TX

Addresses

Primary practice location

425 Pinson Rd
Ste M PMB 1027
Forney, TX 75126-9774

Mailing address

425 Pinson Rd
Ste M PMB 1027
Forney, TX 75126-9774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20241106001270 MO Practitioner - Nurse Practitioner 9638603111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
826532TXMDRegistered Nurse
AP1154144TXMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1124612684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINSON RD",
            "address_2": "STE M PMB 1027",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751269774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINSON RD",
            "address_2": "STE M PMB 1027",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751269774",
            "telephone_number": "903-689-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIKADA",
        "first_name": "OMAH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP1154144",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "826532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.