Individual provider Active NPI

Ngombe Yared Bitendelo, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rosenberg, TX
National Provider Identifier
1205469780
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP144928 Issued in TX
Practice address
24200 Southwest Fwy Ste 356
Rosenberg, TX 77471-5985
Phone
(202) 621-4928
NPI assigned
Feb 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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 AP144928 TX Primary

Addresses

Primary practice location

24200 Southwest Fwy Ste 356
Rosenberg, TX 77471-5985

Mailing address

24200 Southwest Fwy Ste 356
Rosenberg, TX 77471-5985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP144928TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
1A Psychiatry Associates, P.a. Psychiatric/Mental Health CurrentSince Feb 16, 2020 Accepting new patients
Rescue the World Psychiatric/Mental Health CurrentSince Aug 2, 2020 Accepting new patients

Locations

24200 Southwest Fwy
Ste 356
Rosenberg, TX 77471
Phone (202) 621-4928

Organizations & group practices 2

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1205469780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 SOUTHWEST FWY STE 356",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 SOUTHWEST FWY STE 356",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715985",
            "telephone_number": "202-621-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITENDELO",
        "first_name": "NGOMBE",
        "middle_name": "YARED",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP144928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.