Individual provider Active NPI

Telema Dikibujiri Nga, M.D

  • Neonatal-Perinatal Medicine Physician
  • Longview, TX
National Provider Identifier
1184916769
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
R2186 Issued in TX
Practice address
Longview Regional Medical Center
2901 North Fourth Street
Longview, TX 75605
Phone
(856) 782-2212
NPI assigned
May 13, 2011
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X R2186 TX Primary

Addresses

Primary practice location

Longview Regional Medical Center
2901 North Fourth Street
Longview, TX 75605

Mailing address

PO Box 732973
Dallas, TX 75373-2973
Phone (817) 702-2450

Other identifiers 1

IdentifierTypeStateIssuer
372933701MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180823002763 TX Practitioner - Pediatric Medicine 3779872049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2186TXMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Behavioral Care PLLC Current Accepting new patients
Idt Enterprise LLC Current Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Jun 1, 2018 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Jul 15, 2019 Accepting new patients
Tarrant County Hospital District Past Accepting new patients

Locations

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

2300 Lone Star Rd
Mansfield, TX 76063
Phone (682) 341-5000

Organizations & group practices 5

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1184916769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732973",
            "telephone_number": "817-702-2450",
            "fax_number": "817-702-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LONGVIEW REGIONAL MEDICAL CENTER",
            "address_2": "2901 NORTH FOURTH STREET",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75605",
            "telephone_number": "856-782-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGA",
        "first_name": "TELEMA",
        "middle_name": "DIKIBUJIRI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "R2186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372933701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.