Individual provider Active NPI

Renata J Peyreau, FNP-C, GNP-C, RNFA

  • Nurse Practitioner
  • Whitehouse, TX
National Provider Identifier
1316188758
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
727437 Issued in TX
Practice address
15632 State Highway 110 S
19
Whitehouse, TX 75791-9384
Phone
(903) 871-2132
Fax
(903) 871-2333
NPI assigned
Mar 16, 2009
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 727437 TX Primary

Addresses

Primary practice location

15632 State Highway 110 S
19
Whitehouse, TX 75791-9384

Mailing address

15632 State Highway 110 S
19
Whitehouse, TX 75791-9384
Phone (903) 871-2132

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
I20120416000795 TX Practitioner - Nurse Practitioner 2264693399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Internal Medicine Associates, P.aGroup PAC ID 3476541731, 14 clinicians

Practice addresses (Care Compare)

1910 Roseland Blvd
Tyler, TX 75701-4246
Phone (903) 533-0644

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
727437TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Internal Medicine Associates, P.a. Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Neurological & Orthopedic Associates of Texas, LLC PastSince Apr 5, 2012 Accepting new patients

Locations

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1910 Roseland Blvd
Tyler, TX 75701
Phone (903) 533-0644

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADCFBA
  • Direct secure messaging: renata.peyreau@tima.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1316188758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15632 STATE HIGHWAY 110 S",
            "address_2": "19",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757919384",
            "telephone_number": "903-871-2132",
            "fax_number": "903-871-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15632 STATE HIGHWAY 110 S",
            "address_2": "19",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757919384",
            "telephone_number": "903-871-2132",
            "fax_number": "903-871-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYREAU",
        "first_name": "RENATA",
        "middle_name": "J",
        "credential": "FNP-C, GNP-C, RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "727437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehouse, TX

Sources for this page

Verify at the official NPI Registry.