Individual provider Active NPI

Silas Mithika Mwambia

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1508468554
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1019221 Issued in TX
Practice address
5508 Vicksburg Dr
Arlington, TX 76017-4984
Phone
(817) 704-9197
NPI assigned
Nov 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1019221 TX Primary

Addresses

Primary practice location

5508 Vicksburg Dr
Arlington, TX 76017-4984

Mailing address

5508 Vicksburg Dr
Arlington, TX 76017-4984
Phone (817) 704-9197

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
I20240727000496 TX Practitioner - Nurse Practitioner 3476099367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

4701 Boat Club Rd
Suite 325
Fort Worth, TX 76135-2120
Phone (817) 238-1950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1019221TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince May 18, 2024 Accepting new patients
Texas Health Physicians Group CurrentSince May 18, 2024 Accepting new patients
Texas Health Physicians Group Current Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4701 Boat Club Rd
Ste 325
Fort Worth, TX 76135
Phone (817) 238-1950

Interoperability endpoints

  • Direct secure messaging: smwambia2023405@direct.texashealth.org

Organizations & group practices 3

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1508468554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 VICKSBURG DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174984",
            "telephone_number": "817-704-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 VICKSBURG DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174984",
            "telephone_number": "817-704-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWAMBIA",
        "first_name": "SILAS",
        "middle_name": "MITHIKA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1019221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.