NPIMap

Individual provider Active NPI

Nyamsick Agum Oma

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1194359117
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP144640 Issued in TX
Practice address
10851 Scarsdale Blvd Ste 160
Houston, TX 77089-5737
Phone
(281) 824-1480
Fax
(281) 220-6407
NPI assigned
Feb 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 AP144640 TX Primary

Addresses

Primary practice location

10851 Scarsdale Blvd Ste 160
Houston, TX 77089-5737

Mailing address

3707 Basalt St
Iowa Colony, TX 77583-1578
Phone (310) 462-7068

Other practice location 1

104 Whispering Pines Ave
Friendswood, TX 77546-4911
Phone (281) 819-1438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514001366 TX Practitioner - Nurse Practitioner 3577994128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen F Austin Community Health Center, Inc.Group PAC ID 6204977127, 95 clinicians

Practice addresses (Care Compare)

1111 W Adoue St
Alvin, TX 77511-2718
Phone 28182414801594

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP144640TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F. Austin Community Health Center, Inc. CurrentSince Mar 18, 2020 Accepting new patients
Stephen F Austin Community Health Center,Inc CurrentSince Mar 18, 2020 Accepting new patients

Locations

1111 W Adoue St
Alvin, TX 77511
Phone 2818241480 ext. 1594

10851 Scarsdale Blvd
Ste 160
Houston, TX 77089
Phone (281) 464-3780

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1194359117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 BASALT ST",
            "city": "IOWA COLONY",
            "state": "TX",
            "postal_code": "775831578",
            "telephone_number": "310-462-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10851 SCARSDALE BLVD STE 160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770895737",
            "telephone_number": "281-824-1480",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Whispering Pines Ave",
            "address_purpose": "LOCATION",
            "city": "Friendswood",
            "state": "TX",
            "postal_code": "775464911",
            "country_code": "US",
            "telephone_number": "281-819-1438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUM OMA",
        "first_name": "NYAMSICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP144640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.