Collins Iyamah, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

270410 Issued in AZ

Practice address

1500 N Wilmot Rd Ste A200
Tucson, AZ 85712-4416

Phone

(817) 420-2968

Fax

(682) 282-3115

NPI assigned

Aug 17, 2021

Last updated

Mar 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX, AZ, NM3 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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Mental and Wellness Center Limited Liability CompanyGroup PAC ID 2163942731, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• US Universal Health Care Services LLC

  • Home Health Agency
  • Duncanville, TX
  • NPI 1710215694

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

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.

• Beacon Mental and Wellness Center Limited Liability Company

  • Psychiatric/Mental Health Nurse Practitioner
  • Desoto, TX
  • NPI 1336983709
  Medicare reassignment Care Compare group
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  AZ, Single Specialty

  Medicare reassignment NPD
• US Universal Health Care Services LLC

  • Home Health Agency
  • Duncanville, TX
  • NPI 1710215694
  NPD Authorized official
• US Universal Hospice Inc

  • Community Based Hospice Care Agency
  • Duncanville, TX
  • NPI 1255896833
  NPD Authorized official
• Tucson Counseling PLLC

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1740529460
  Medicare reassignment
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, NM

  Medicare reassignment
• Compassion Behavioral Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Duncanville, TX
  • NPI 1437826039
  Authorized official Same address or phone
• Tucson Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1285473249

  Single Specialty

  NPD

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1366118671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N WILMOT RD STE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124416",
            "telephone_number": "520-403-4749",
            "fax_number": "888-851-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WILMOT RD STE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124416",
            "telephone_number": "817-420-2968",
            "fax_number": "682-282-3115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 S Main St Ste 101F",
            "address_purpose": "LOCATION",
            "city": "Duncanville",
            "state": "TX",
            "postal_code": "751164765",
            "country_code": "US",
            "telephone_number": "817-420-2858",
            "fax_number": "682-282-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IYAMAH",
        "first_name": "COLLINS",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "2021028178",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1053243",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403918",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61390990",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "270410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PRIVACYLOK",
            "affiliation": "N",
            "endpointDescription": "PRIVACYLOK",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2955 Bandera",
            "city": "Grand Prairie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750545553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PRIVACYLOK",
            "affiliation": "N",
            "endpointDescription": "PRIVACYLOK",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 S Main St Ste 101F",
            "city": "Duncanville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751164765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ivy 2 Dental PLLC
• Ivy 2 Dental, PLLC
• Kayla Iwahashi, PA-C
• Alexa Iwaniuk, COTA/L
• Carlos Ixta
• Hridaya Premnath Iyer, M.D
• Oluwatosin Busola Iyun, M.D.
• Rommel Alberto Izaguirre Pereira, MD
• Illona Yakovlevna Izmailova, NP
• J Benach PSYD LLC

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.