Ayesha Bacchus

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1102199 Issued in TX

Practice address

16040 Park Valley Dr Ste 227
Round Rock, TX 78681-3596

Phone

(512) 255-7337

NPI assigned

Dec 19, 2022

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ayesha.bacchus.1@8363.direct.athenahealth.com

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.

• Dell Children'S Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943
  Medicare reassignment NPD
• Dell Children'S Medical Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD
• Dell Children'S Medical Group

  • Pediatrics Physician
  • Round Rock, TX
  • NPI 1790103869
  NPD

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1477265759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16040 PARK VALLEY DR STE 227",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16040 PARK VALLEY DR STE 227",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813596",
            "telephone_number": "512-255-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "AYESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1102199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karine Babayan
• Babson Therapies Incorporated
• Karen Babson, MA;CCC SLP
• Vanessa Anne Baca
• Edgar Bacares, MD
• Baylie Rayanne Baccinelli
• Aya Badawy
• Sandeep Badyal, MD
• Laura Lee Baer, MD
• D'Asiah Bagley, RBT

• Pediatric Nurse Practitioner in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.