Individual provider Active NPI

Tatianna Mondaini Marx, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1215412788
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138929 Issued in TX
Practice address
3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone
(251) 916-3805
NPI assigned
Oct 1, 2018
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138929 TX Primary
Registered Nurse First Assistant 163WR0006X 941717 TX

Addresses

Primary practice location

3551 Roger Brooke Dr
San Antonio, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone (210) 916-3805

Other names 1

  • Tatianna Mondaini Former name

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
I20181128001809 TX Practitioner - Nurse Practitioner 3173867355 Reassigns benefits to 2 organizations

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
Rocky Mountain Kidney Care Professional Service CorpGroup PAC ID 2860929833, 8 clinicians

Practice addresses (Care Compare)

1621 N Central Expy
Suite 200
Richardson, TX 75080-3504
Phone (720) 696-0852

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
941717TXMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Kidney Care Professional Service Corp CurrentSince Mar 17, 2025 Accepting new patients
NSC Consultants, PA CurrentSince Oct 13, 2021 Accepting new patients
Premier Dialysis - Dsi, LLC Past Accepting new patients
M. Reza Mizani, M.D., P.a. PastSince Sep 1, 2021 Accepting new patients

Locations

100 E House St
Alvin, TX 77511
Phone (281) 245-1123

203 W Randol Mill Rd
Arlington, TX 76011
Phone (817) 275-7787

801 E Border St
Arlington, TX 76010
Phone (817) 539-6744

265 SE John Jones Dr
Burleson, TX 76028
Phone (817) 447-7478

8181 N Stadium Dr
Ste 100
Houston, TX 77054
Phone (713) 425-1969

1621 N Central Expy
#200
Richardson, TX 75080
Phone (206) 223-5001

4611 Centerview
San Antonio, TX 78228
Phone (210) 255-8935

6518 Memorial Dr
Texas City, TX 77591
Phone (409) 965-0318

Interoperability endpoints

  • Direct secure messaging: tatianna.marx.1@19427.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1215412788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3805",
            "fax_number": "210-916-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "251-916-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "TATIANNA",
        "middle_name": "MONDAINI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138929",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "941717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATIANNA",
            "last_name": "MONDAINI",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.