Individual provider Active NPI

Maria Agnes Regondola

  • Acute Care Nurse Practitioner
  • Baytown, TX
National Provider Identifier
1164232179
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1179938 Issued in TX
Practice address
4401 Garth Rd
Baytown, TX 77521-2122
Phone
(281) 420-8600
Fax
(281) 420-8414
NPI assigned
Jan 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1179938 TX Primary

Addresses

Primary practice location

4401 Garth Rd
Baytown, TX 77521-2122

Mailing address

8025 Village Dr
Beaumont, TX 77713-8486
Phone (409) 658-9558

Other names 1

  • Agnes Regondola Professional name

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
I20250228001742 TX Practitioner - Nurse Practitioner 5698295079 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Mar 24, 2025 Accepting new patients
TMH Physician Associates PLLC CurrentSince Mar 24, 2025 Accepting new patients
Methodist Radiology Associates, PLLC Past Accepting new patients

Locations

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

Organizations & group practices 4

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": "1736467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1164232179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 VILLAGE DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777138486",
            "telephone_number": "409-658-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 GARTH RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775212122",
            "telephone_number": "281-420-8600",
            "fax_number": "281-420-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGONDOLA",
        "first_name": "MARIA",
        "middle_name": "AGNES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1179938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "REGONDOLA",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Baytown, TX

Sources for this page

Verify at the official NPI Registry.