Individual provider Active NPI

Ginikanwa Agu, NP

  • Family Nurse Practitioner
  • Irving, TX
National Provider Identifier
1396458287
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
854628 Issued in TX
Practice address
6121 N Hwy 161 Ste 300
Irving, TX 75038-2270
Phone
(469) 647-4705
NPI assigned
Jan 5, 2023
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 854628 TX Primary
Family Nurse Practitioner 363LF0000X 1085714 TX

Addresses

Primary practice location

6121 N Hwy 161 Ste 300
Irving, TX 75038-2270

Mailing address

PO Box 845347
Dallas, TX 75284-7208

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
I20230724001777 TX Practitioner - Nurse Practitioner 5698135515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6121 N Hwy 161
Suite 200
Irving, TX 75038-2270
Phone (214) 648-4805

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1085714TXMDFamily Nurse Practitioner
854628TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 23, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jun 23, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Sep 1, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

6121 N State Highway 161
Ste 300
Irving, TX 75038
Phone (214) 964-0670

6121 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 964-0600

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

Organizations & group practices 5

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 1

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1396458287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N HWY 161 STE 300",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382270",
            "telephone_number": "469-647-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGU",
        "first_name": "GINIKANWA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "854628",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1085714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.