Individual provider Active NPI

Melinda K Hoffman, RN CFNP

  • Family Nurse Practitioner
  • Boerne, TX
National Provider Identifier
1164415006
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130662 Issued in TX
Practice address
113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683
Phone
(830) 267-4575
Fax
(830) 267-4575
NPI assigned
Aug 25, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 AP130662 TX Primary
Nurse Practitioner 363L00000X 71001866A IN

Addresses

Primary practice location

113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683

Mailing address

113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683
Phone (830) 267-4575

Other identifiers 2

IdentifierTypeStateIssuer
200941040MedicaidIN
000000552332OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20171129001035 CO Practitioner - Nurse Practitioner 4082701487 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP130662TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers CurrentSince Oct 30, 2017 Accepting new patients
Peak Vista Community Health Centers CurrentSince Oct 30, 2017 Accepting new patients

Locations

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

3205 N Academy Blvd
Ste 130
Colorado Springs, CO 80917
Phone (719) 344-6873

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1164415006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PLEASANT VALLEY DR STE 210",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780065683",
            "telephone_number": "830-267-4575",
            "fax_number": "830-267-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 PLEASANT VALLEY DR STE 210",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780065683",
            "telephone_number": "830-267-4575",
            "fax_number": "830-267-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MELINDA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "RN CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130662",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001866A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200941040",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000552332",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.