Individual provider Active NPI

Nicolina Egydia Mboya, FNP-BC

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1245705383
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139749 Issued in TX
Practice address
1050 W Arkansas LN
Arlington, TX 76013-6308
Phone
(817) 702-1100
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139749 TX Primary

Addresses

Primary practice location

1050 W Arkansas LN
Arlington, TX 76013-6308

Mailing address

3149 Lackland Rd Ste 104
Fort Worth, TX 76116-4109
Phone (817) 886-8890

Other practice location 1

1305 Airport Fwy Ste 302
Bedford, TX 76021
Phone (817) 283-6995

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
I20190307000443 TX Practitioner - Nurse Practitioner 9739428897 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
Group practices
Health First Care Clinic LLCGroup PAC ID 6103298823, 2 clinicians

Practice addresses (Care Compare)

350 Westpark Way
Suite 120
Euless, TX 76040-3731
Phone (817) 345-6443

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Care Clinic, LLC CurrentSince Nov 19, 2022 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Aug 2, 2021 Accepting new patients

Locations

1050 W Arkansas Ln
Arlington, TX 76013
Phone (817) 277-6555

350 Westpark Way
Ste 120
Euless, TX 76040
Phone (817) 345-6443

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

Interoperability endpoints

  • Direct secure messaging: nfranklin52215@direct.jpshealth.org

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1245705383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 LACKLAND RD STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761164109",
            "telephone_number": "817-886-8890",
            "fax_number": "817-886-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W ARKANSAS LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136308",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Airport Fwy Ste 302",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "TX",
            "postal_code": "76021",
            "country_code": "US",
            "telephone_number": "817-283-6995",
            "fax_number": "817-952-7011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBOYA",
        "first_name": "NICOLINA",
        "middle_name": "EGYDIA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.