Individual provider Active NPI

Pacificah Nyangau, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • The Woodlands, TX
National Provider Identifier
1417516519
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP140988 Issued in TX
Practice address
25301 Borough Park Dr Ste 220
The Woodlands, TX 77380-3562
Phone
(281) 651-8474
NPI assigned
Jun 12, 2019
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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 AP140988 TX Primary

Addresses

Primary practice location

25301 Borough Park Dr Ste 220
The Woodlands, TX 77380-3562

Mailing address

2129 FM 2920 Rd Ste 171
Spring, TX 77388-3671
Phone (281) 651-8474

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL HER Other
Other URL EHR
Other URL EHR Health Information Exchange (HIE)

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
I20200625000266 TX Practitioner - Nurse Practitioner 3173944451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25301 Borough Park Dr
Suite 220
The Woodlands, TX 77380-3562
Phone (281) 651-8474

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Equanimity Behavioral Health and Consultation Services CurrentSince Feb 7, 2020 Accepting new patients

Locations

1006 Windsor Lakes Blvd
Ste 200
Conroe, TX 77384
Phone (281) 292-7246

2129 FM 2920 Rd
Ste 171
Spring, TX 77388
Phone (281) 378-6001

25301 Borough Park Dr
Ste 220
The Woodlands, TX 77380
Phone (281) 651-8474

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1417516519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 FM 2920 RD STE 171",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773883671",
            "telephone_number": "281-651-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25301 BOROUGH PARK DR STE 220",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803562",
            "telephone_number": "281-651-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYANGAU",
        "first_name": "PACIFICAH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP140988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HER",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "perfect serve",
            "address_1": "7600 Beechnut St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770744302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "1006 Windsor Lakes Blvd Ste 200",
            "city": "Conroe",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773844975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OFFICE ALLY",
            "address_1": "25301 Borough Park Dr Ste 220",
            "city": "The Woodlands",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773803562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.