Individual provider Active NPI

Fadeke Amao

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1417585530
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1205461 Issued in TX
Practice address
1155 Dairy Ashford Rd Ste 560
Houston, TX 77079-3035
Phone
(713) 799-2200
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1205461 TX Primary

Addresses

Primary practice location

1155 Dairy Ashford Rd Ste 560
Houston, TX 77079-3035

Mailing address

1155 Dairy Ashford Rd Ste 560
Houston, TX 77079-3035

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
I20260414001433 TX Practitioner - Nurse Practitioner 8527534924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1205461TXMDNurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1417585530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 DAIRY ASHFORD RD STE 560",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 DAIRY ASHFORD RD STE 560",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793035",
            "telephone_number": "713-799-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAO",
        "first_name": "FADEKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1205461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.