Individual provider Active NPI

Anaiya Baukman, M.S., LPA

  • Clinical Psychologist
  • Irving, TX
National Provider Identifier
1164137188
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
40159 Issued in TX
Practice address
1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409
Phone
(214) 940-9089
NPI assigned
Jan 16, 2023
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 40159 TX Primary

Addresses

Primary practice location

1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409

Mailing address

9595 Rombauer Rd Apt 202
Coppell, TX 75019-1203
Phone (484) 994-9478

Other practice location 1

9595 Rombauer Rd # 202
Coppell, TX 75019-5891
Phone (484) 994-9478

Other identifiers 1

IdentifierTypeStateIssuer
40159OtherTXTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40159TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Psychological Assessments, PLLC CurrentSince May 26, 2024 Accepting new patients
Dallas Therapeutic Services PLLC PastSince May 26, 2024 Accepting new patients

Locations

1175 Kinwest Pkwy
Ste 100
Irving, TX 75063
Phone (214) 940-9089

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1164137188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9595 ROMBAUER RD APT 202",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750191203",
            "telephone_number": "484-994-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 KINWEST PKWY STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633409",
            "telephone_number": "214-940-9089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9595 Rombauer Rd # 202",
            "address_purpose": "LOCATION",
            "city": "Coppell",
            "state": "TX",
            "postal_code": "750195891",
            "country_code": "US",
            "telephone_number": "484-994-9478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUKMAN",
        "first_name": "ANAIYA",
        "name_prefix": "Ms.",
        "credential": "M.S., LPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL",
            "identifier": "40159",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.