Individual provider Active NPI

Bintou Sarr

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1457078792
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1077699 Issued in TX
Practice address
4818 Edinburgh Dr
Tyler, TX 75703-2701
Phone
(903) 283-5436
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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 1077699 TX
Nurse Practitioner 363L00000X 1077699 TX Primary

Addresses

Primary practice location

4818 Edinburgh Dr
Tyler, TX 75703-2701

Mailing address

4818 Edinburgh Dr
Tyler, TX 75703-2701
Phone (903) 283-5436

Other practice location 1

3131 Troup Hwy
Tyler, TX 75701-8350
Phone (903) 510-7006

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
I20230120000953 TX Practitioner - Nurse Practitioner 7416328943 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 16, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 16, 2023 Accepting new patients

Locations

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

3131 Troup Hwy
Tyler, TX 75701
Phone (903) 510-7000

Organizations & group practices 2

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": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1457078792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4818 EDINBURGH DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032701",
            "telephone_number": "903-283-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 EDINBURGH DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032701",
            "telephone_number": "903-283-5436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 Troup Hwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018350",
            "country_code": "US",
            "telephone_number": "903-510-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARR",
        "first_name": "BINTOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1077699",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1077699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.