Individual provider Active NPI

Kimberly Anne Sakovich, WHNP

  • Women's Health Nurse Practitioner
  • Irving, TX
National Provider Identifier
1750612792
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
658263 Issued in TX
Practice address
3501 N Macarthur Blvd
Suite 500
Irving, TX 75062-3651
Phone
(972) 256-3700
Fax
(972) 258-9887
NPI assigned
Jan 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 658263 TX Primary

Addresses

Primary practice location

3501 N Macarthur Blvd
Suite 500
Irving, TX 75062-3651

Mailing address

3501 N Macarthur Blvd
Suite 500
Irving, TX 75062-3651
Phone (972) 256-3700

Other identifiers 2

IdentifierTypeStateIssuer
816N89OtherTXBC/BS
219270001MedicaidTX

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
I20100630000107 TX Practitioner - Nurse Practitioner 1052442399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macarthur Medical Center PLLCGroup PAC ID 8426102625, 26 clinicians

Practice addresses (Care Compare)

3501 N Macarthur Blvd
Suite 500
Irving, TX 75062-3675
Phone (972) 256-3700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658263TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macarthur Medical Center, PLLC Women'S Health CurrentSince Mar 18, 2010 Accepting new patients
Women'S Integrated Healthcare, P.a. Women'S Health Current Accepting new patients

Locations

307 Westpark Way
Euless, TX 76040
Phone (682) 253-5437

2101 Westpark Ct
Ste 200
Euless, TX 76040

3025 N Tarrant Pkwy
Ste 150
Fort Worth, TX 76177
Phone (817) 416-2229

3095 Kingswood Blvd
Ste 250
Grand Prairie, TX 75052
Phone 2143582300 ext. 6225

3501 N MacArthur Blvd
Ste 500
Irving, TX 75062
Phone (972) 786-0330

245 W State Highway 114
Ste 330
Southlake, TX 76092
Phone (817) 416-2229

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8654/brand/1/csg/1/fhir/r4

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": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1750612792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623651",
            "telephone_number": "972-256-3700",
            "fax_number": "972-258-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623651",
            "telephone_number": "972-256-3700",
            "fax_number": "972-258-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKOVICH",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "658263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "816N89",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219270001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.