Individual provider Active NPI

Yaimara Gonzalez Pantoja, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1679062152
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP137470 Issued in TX
Practice address
5901 Bellaire Blvd Ste 104
Houston, TX 77081-5515
Phone
(832) 834-4688
Fax
(832) 834-4687
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 AP137470 TX Primary

Addresses

Primary practice location

5901 Bellaire Blvd Ste 104
Houston, TX 77081-5515

Mailing address

5901 Bellaire Blvd Ste 104
Houston, TX 77081-5515
Phone (832) 834-4688

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
I20210326000817 TX Practitioner - Nurse Practitioner 9335556919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5901 Bellaire Blvd
Suite 104
Houston, TX 77081-5515
Phone (832) 834-4688

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP137470TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Clinica Bellaire, PLLC CurrentSince Dec 6, 2020 Accepting new patients
Mi Clinica Medica Bellaire, PLLC Family CurrentSince Dec 1, 2020 Accepting new patients

Locations

5901 Bellaire Blvd
Ste 104
Houston, TX 77081
Phone (832) 638-5975

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1679062152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 BELLAIRE BLVD STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770815515",
            "telephone_number": "832-834-4688",
            "fax_number": "832-834-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BELLAIRE BLVD STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770815515",
            "telephone_number": "832-834-4688",
            "fax_number": "832-834-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PANTOJA",
        "first_name": "YAIMARA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.