Peris B Momanyi

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1177246 Issued in TX

Practice address

3531 Ponderosa Dr
Grand Prairie, TX 75052-7858

Phone

(469) 358-9331

NPI assigned

Dec 20, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medi- Elite, PCGroup PAC ID 0648594309, 3 clinicians

Practice addresses (Care Compare)

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.

• Medi- Elite, PC

  • Primary Care Clinic/Center
  • Bedford, TX
  • NPI 1528330792
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1194533356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 PONDEROSA DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 PONDEROSA DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527858",
            "telephone_number": "469-358-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMANYI",
        "first_name": "PERIS",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1177246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obah Mohamed
• Niya Fouzy Mohammed, PHARMD
• Sara Mohsen
• Mojisola Frazier
• Rubyann Molina-Garcia, PH.D, LCDC
• Ruby Mondragon, RN
• Patrick Anayo Moneke
• Veronica Monono
• Norberto J C Montani, MD
• Daijah Marie Montes, RBT

• Family Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.