Organization Active NPI

Amicable Psychiatry MD, PA

  • Psychiatry Physician
  • Grapevine, TX
National Provider Identifier
1295152148
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
AMICABLE PSYCHIATRY MD, PA
Practice address
833 E Northwest Hwy Ste 400
Grapevine, TX 76051-3302
Phone
(817) 778-0191
Fax
(817) 421-2940
NPI assigned
Mar 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. Omotayo Onanuga, MDNPI 1518989474
Title
MD
Phone
(817) 771-0191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

833 E Northwest Hwy Ste 400
Grapevine, TX 76051-3302

Mailing address

PO Box 2043
Grapevine, TX 76099-2043
Phone (817) 778-0191

Other names 1

  • NEW AGE BEHAVIORAL HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140708000942 TX Part B Supplier - Clinic/Group Practice 9032334040 Receives reassigned benefits from 1 practitioner
Practice locations: Grapevine, TX

National Provider Directory

National Provider Directory

Locations

5601 Bridge St
#Forth
Fort Worth, TX 76112
Phone (817) 586-4406

1643 Lancaster Dr
Ste 305
Grapevine, TX 76051
Phone (817) 410-2030

833 E Northwest Hwy
Ste 400
Grapevine, TX 76051
Phone (817) 778-0191

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1295152148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2043",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760992043",
            "telephone_number": "817-778-0191",
            "fax_number": "817-421-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E NORTHWEST HWY STE 400",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513302",
            "telephone_number": "817-778-0191",
            "fax_number": "817-421-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMICABLE PSYCHIATRY MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "ONANUGA",
        "authorized_official_first_name": "OMOTAYO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "817-771-0191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW AGE BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.