Bibin Sanju, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1228590 Issued in TX

Practice address

2800 E Texas Highway 114
Ste 350
Trophy Club, TX 76262-5033

Phone

(855) 204-2502

NPI assigned

Mar 9, 2026

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kotel AtxGroup PAC ID 9537578810, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kotel Atx

  • Adult Mental Health Clinic/Center
  • Austin, TX
  • NPI 1568055192
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1538015748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E TEXAS HIGHWAY 114",
            "address_2": "STE 350",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625033",
            "telephone_number": "855-204-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E TEXAS HIGHWAY 114",
            "address_2": "STE 350",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625033",
            "telephone_number": "855-204-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJU",
        "first_name": "BIBIN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1228590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Lynn Rice, M.S.
• Alexandra Richmond
• Kathryn Wright Rodgers, PHARM D.
• Jenna Romig
• Salt Optical LLC
• Santas Workshop PA
• Michelle Leann Seck, DPT
• Sharon Stha Dental
• Cynthia Goodwin Smith, LCSW
• Justin Ray Smith, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.