Mary Taylor Ibarra, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP132388 Issued in TX

Practice address

1400 S Coulter St
Amarillo, TX 79106-1786

Phone

(806) 414-9100

Fax

(806) 354-5717

NPI assigned

Oct 31, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omar Bazzaz MD PLLCGroup PAC ID 2365933314, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bsa Compassion Home Care Home health agency, Amarillo, TX, CCN 677943
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Omar Bazzaz MD PLLC

  • Internal Medicine Physician
  • Amarillo, TX
  • NPI 1073481206
  Medicare reassignment Care Compare group NPD
• Texas Tech University Health Sciences Center Amarillo

  • Internal Medicine Physician
  • Amarillo, TX
  • NPI 1871525840
  Medicare reassignment NPD
• Texas Tech University Health Sciences Center

  • Pharmacy
  • Lubbock, TX
  • NPI 1609810977
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Camden Bay LTD

  • Home Health Agency
  • Amarillo, TX
  • NPI 1245426527
  Care Compare affiliation

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1194277665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBARRA",
        "first_name": "MARY",
        "middle_name": "TAYLOR",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132388",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP132388",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200678790 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366677802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366677801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54485525",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hydrolux IV Bar PLLC
• William Jere Iafrate, PT, DPT
• Ana D Ibarra, LMSW
• Brenda Ibarra, RBT
• Jorge I Ibarra, LPC-A
• Dennis A Ice, MD
• Ahmad Imam, M.D.
• Hassan Imam, M.D
• Immunity Access LLC
• In Motion on-Site Rehab Services LLC

• Acute Care Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.