Mical Isaly Pacheco, MSN, APRN-CNP, PM HN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

226790 Issued in OK

Practice address

4922 E 73Rd St
Tulsa, OK 74136-7007

Phone

(918) 340-6460

Fax

(918) 926-3376

NPI assigned

Jun 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Saint Louis University School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mind Rejuvenation, LLC.Group PAC ID 9335593672, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Mind Rejuvenation, LLC.

  • Psychiatry Physician
  • Tulsa, OK
  • NPI 1811527518
  Medicare reassignment Care Compare group NPD
• Indian Health Care Resource Center

  • Clinic/Center
  • Tulsa, OK
  • NPI 1427034958
  NPD
• Indian Health Care Resource Center of Tulsa, Inc.

  • Pharmacy
  • Tulsa, OK
  • NPI 1457447609
  NPD (past)

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1396429098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 E 73RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367007",
            "telephone_number": "918-340-6460",
            "fax_number": "918-926-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 E 73RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367007",
            "telephone_number": "918-340-6460",
            "fax_number": "918-926-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MICAL",
        "middle_name": "ISALY",
        "credential": "MSN, APRN-CNP, PM HN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "226790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201164390A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danoush Paborji, DO
• Courtney Pace, APRN-CNP
• James Pace
• Michael Pace
• Kimberly Ann Pacheco, LPN
• Rafaela Pacheco, COTA
• Valeska Mahli Pacheco
• Pacific Physician Services, LLC
• Kryslyn Renea Packard Wilson
• Joseph Louis Padalino, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.