Caesasonia Pascual Agatep, NP
Individual provider Active NPI Nurse Practitioner · San Angelo, TX
NPI 1154748671 · NPPES record last updated Dec 6, 2019
Key facts
- NPI
- 1154748671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP125367 (TX)
- Practice address
- 3501 Knickerbocker Rd
San Angelo, TX 76904-7610 - Phone
- (325) 949-9511
- Fax
- (325) 947-6550
- NPI assigned
- Mar 21, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shannon Clinic
Practice addresses (Care Compare)
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500
Hospital & facility affiliations
- Shannon Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.63 of 100
- Quality
- 78.21
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 67.22
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141001002453 | TX | Practitioner - Nurse Practitioner | 6901026657 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 747144 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Clinic | Current |
Accepting new patients |
Locations
120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511
3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361
Interoperability endpoints
- cagatep40268@shannonhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 747144 | TX | |
| Nurse Practitioner | 363L00000X | AP125367 | TX | Yes |
Addresses
Primary practice location
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Mailing address
3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 949-9511
Other providers in San Angelo, TX
- Adc Inc
- Jerre Alison Ader
- Adult Enrichment Center, Inc.
- Aegis Counseling PLLC
- Affinity Distribution, Inc
- Babatunde O. Agbola
- Jennifer Agee
- Arthur Aguilar
- Kandace Ryan Aguilar
- Ngozi Oby Agwuenu
All providers in San Angelo, TX · Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.