Faridy Maya Mombeleur

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP140998 Issued in TX

Practice address

2000 S FM 51 Ste C
Decatur, TX 76234-3702

Phone

(940) 626-1848

Fax

(940) 626-1849

NPI assigned

Mar 20, 2019

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, TX, AZ, MD4 enrollments

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 4

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Haroon Siddique, MD, PAGroup PAC ID 5092874057, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: faridy.mombeleur.1@25899.direct.athenahealth.com

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.

• Haroon Siddique, MD, PA

  • Psychiatry Physician
  • Decatur, TX
  • NPI 1467614768
  Medicare reassignment Care Compare group
• Associates in Counseling and Psychotherapy

  • Clinical Psychologist
  • New Albany, IN
  • NPI 1801948062
  Medicare reassignment NPD
• Community Hospital Association, Inc.

  dba Wickenburg Community Hospital

  • Critical Access Hospital
  • Wickenburg, AZ
  • NPI 1841282852
  Medicare reassignment NPD
• White Mountain Regional Medical Center

  • Critical Access Hospital
  • Springerville, AZ
  • NPI 1699766592
  Medicare reassignment NPD
• Holistic Behavioral Solutions Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Fort Worth, TX
  • NPI 1174097661
  NPD Authorized official
• Mind Power LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sheridan, WY
  • NPI 1609731934
  NPD Authorized official
• Community Hospital Association, Inc.

  dba Community Hospital Clinic-Wittmann

  • Rural Health Clinic/Center
  • Wittmann, AZ
  • NPI 1770097123
  NPD
• Associates in Counseling and Psychtherapy

  • Community/Behavioral Health Agency
  • New Albany, IN
  • NPI 1114330271
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1245790914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 S FM 51 STE 400",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343788",
            "telephone_number": "940-626-1848",
            "fax_number": "940-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S FM 51 STE C",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343702",
            "telephone_number": "940-626-1848",
            "fax_number": "940-626-1849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 S Mountain Ave",
            "address_purpose": "LOCATION",
            "city": "Springerville",
            "state": "AZ",
            "postal_code": "859385104",
            "country_code": "US",
            "telephone_number": "928-333-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMBELEUR",
        "first_name": "FARIDY",
        "middle_name": "MAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP140998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mind Above Matter, LLC
• Lisa Ann Minsloff, M.D.
• Julie Catherine Mistic, AU.D.
• Brandon Mitchell
• Christopher Barret Moeder, MD
• Jonathan Tad Montgomery, PT
• Andrea M Morris
• Daniel K Morris, DO
• Jennifer A Mountain, LCSW
• Jennifer Louise Munoz, FNP

• Psychiatric/Mental Health Nurse Practitioner in Decatur, TX
• Providers in Decatur, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.