Individual provider Active NPI

Colin Fomin Aminkeng, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1194208181
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP138662 Issued in TX
Practice address
5372 Fredericksburg Rd BLDG F
San Antonio, TX 78229-3558
Phone
(210) 261-1000
Fax
(210) 615-5731
NPI assigned
Sep 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP138662 TX Primary

Addresses

Primary practice location

5372 Fredericksburg Rd BLDG F
San Antonio, TX 78229-3558

Mailing address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293
Phone (210) 261-1000

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
I20181023003484 TX Practitioner - Nurse Practitioner 3577816420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6800 Park Ten Blvd
San Antonio, TX 78213-4293
Phone (210) 261-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Sep 17, 2018 Accepting new patients

Locations

6800 Park Ten Blvd
Ste 200S
San Antonio, TX 78213
Phone 21026110001060

5372 Fredericksburg Rd
Bldg F
San Antonio, TX 78229
Phone (210) 261-1250

Organizations & group practices 1

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": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1194208181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372 FREDERICKSBURG RD BLDG F",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293558",
            "telephone_number": "210-261-1000",
            "fax_number": "210-615-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMINKENG",
        "first_name": "COLIN",
        "middle_name": "FOMIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-14",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP138662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.