Individual provider Active NPI

Santiago Pompa

  • Psychiatric/Mental Health Nurse Practitioner
  • Edinburg, TX
National Provider Identifier
1316302342
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP129797 Issued in TX
Practice address
1901 S 24TH Ave
Edinburg, TX 78539-6533
Phone
(956) 289-7025
Fax
(956) 289-7257
NPI assigned
Dec 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP129797 TX Primary

Addresses

Primary practice location

1901 S 24TH Ave
Edinburg, TX 78539-6533

Mailing address

1901 S 24TH Ave
Edinburg, TX 78539-6533
Phone (956) 289-7025

Other identifiers 3

IdentifierTypeStateIssuer
138708613MedicaidTX
138708611MedicaidTX
00R945OtherTXMEDICARE

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
I20160714000346 TX Practitioner - Nurse Practitioner 8123310935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1901 S 24TH Ave
Edinburg, TX 78539-6533
Phone (956) 289-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP129797TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tropical Texas Behavioral Health CurrentSince May 10, 2016 Accepting new patients
Tropical Texas Behavioral Health CurrentSince May 10, 2016 Accepting new patients

Locations

1901 S 24th Ave
Edinburg, TX 78539
Phone (956) 289-7025

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1316302342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S 24TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396533",
            "telephone_number": "956-289-7025",
            "fax_number": "956-289-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 24TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396533",
            "telephone_number": "956-289-7025",
            "fax_number": "956-289-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMPA",
        "first_name": "SANTIAGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP129797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138708613",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138708611",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00R945",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.