Individual provider Active NPI

Georgina Aka Fomenky

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1154943686
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1089343 Issued in TX
Practice address
5500 N Macarthur Blvd
Irving, TX 75038-2603
Phone
(972) 518-1325
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1089343 TX Primary
Registered Nurse 163W00000X 800512 TX

Addresses

Primary practice location

5500 N Macarthur Blvd
Irving, TX 75038-2603

Mailing address

5500 N Macarthur Blvd
Irving, TX 75038-2603
Phone (972) 518-1325

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220908001649 TX Practitioner - Nurse Practitioner 6507240637 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
800512TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Telehealth Services of Texas Association Family CurrentSince Mar 18, 2025 Accepting new patients
Omni Senior Care Solutions Current Accepting new patients
Primary Care PLLC Family CurrentSince Mar 18, 2025 Accepting new patients
Minuteclinic Primary Care Texas PLLC Family Current Accepting new patients
Minuteclinic Diagnostic of Texas PLLC CurrentSince Mar 18, 2025 Accepting new patients
Minuteclinic Diagnostic of Texas PLLC Family CurrentSince Mar 18, 2025 Accepting new patients

Locations

1540 E Main St
Allen, TX 75002
Phone (214) 383-9765

5526 S Congress Ave
Austin, TX 78745
Phone (512) 462-3820

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

2469 Bay Area Blvd
Houston, TX 77058
Phone (281) 474-4042

5500 N MacArthur Blvd
Irving, TX 75038
Phone (972) 255-4155

3103 Fry Rd
Katy, TX 77449
Phone (281) 646-2964

5002 W Main St
League City, TX 77573
Phone (281) 557-4374

1413 Oates Dr
Mesquite, TX 75150
Phone (972) 613-7001

9522 Broadway St
Pearland, TX 77584
Phone (713) 436-8151

1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268

5301 Alamo Pkwy
San Antonio, TX 78253
Phone (210) 688-9311

Organizations & group practices 7

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1154943686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382603",
            "telephone_number": "972-518-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382603",
            "telephone_number": "972-518-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKA FOMENKY",
        "first_name": "GEORGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1089343",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "800512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.