Individual provider Active NPI

Peter Kimiti Mwangi, AG-ACNP-BC

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1346788353
Registry record updated Jul 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP132915 Issued in TX
Practice address
2929 Wycliff Ave
Apt 2227
Dallas, TX 75219-2646
Phone
(205) 747-9949
NPI assigned
Feb 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP132915 TX
Nurse Practitioner 363L00000X AP132915 TX Primary

Addresses

Primary practice location

2929 Wycliff Ave
Apt 2227
Dallas, TX 75219-2646

Mailing address

1931 Market Center Blvd Apt 4217
Dallas, TX 75207-3430
Phone (205) 747-9949

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
I20180313000038 TX Practitioner - Nurse Practitioner 4385906296 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

201 Walls Dr
Cleburne, TX 76033-4007
Phone (817) 641-2551

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince Jun 1, 2022 Accepting new patients
Apogee Medical Group Texas PA CurrentSince Feb 1, 2018 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Jun 1, 2022 Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

811 Wright St
Arlington, TX 76012
Phone (817) 960-3500

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

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

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: pmwangi71426@direct.phhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625356800000",
    "number": "1346788353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 MARKET CENTER BLVD APT 4217",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752073430",
            "telephone_number": "205-747-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 WYCLIFF AVE",
            "address_2": "APT 2227",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192646",
            "telephone_number": "205-747-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "PETER",
        "middle_name": "KIMITI",
        "name_prefix": "Dr.",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-09",
        "last_updated": "2021-07-04",
        "certification_date": "2021-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132915",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.