Mildred K Omoongeh, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

231224 Issued in AZ

Practice address

1835 W Missouri Ave
Phoenix, AZ 85015-3046

Phone

(602) 230-0777

NPI assigned

Apr 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Psa Behavioral Health AgencyGroup PAC ID 6305017245, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mildred.omoongeh.1@29290.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.

• Resilient Health, Inc.

  • Community/Behavioral Health Agency
  • Gilbert, AZ
  • NPI 1285150896
  Medicare reassignment Care Compare group NPD
• Pophealthcare Medical Services of Az, PC

  • Nurse Practitioner
  • Tempe, AZ
  • NPI 1760884175
  Medicare reassignment NPD
• Delight Health Solutions

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Phoenix, AZ
  • NPI 1518793132

  Family

  NPD Authorized official
• Pophealthcare Medical Services of Az, PC

  • Family Nurse Practitioner
  • Tempe, AZ
  • NPI 1417652454
  NPD
• Resilient Health, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1790267011
  NPD
• Resilient Health, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1881680452
  NPD

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1760945752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W BEVERLY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850417625",
            "telephone_number": "405-219-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153046",
            "telephone_number": "602-230-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOONGEH",
        "first_name": "MILDRED",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "855808",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "231224",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "231224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omnipotent Health Services
• Omniscript Compounding LLC
• Omniscript Compounding LLC
• Omniscript Compounding LLC
• Olufemi A Omodara, RPH
• Robert Omwoyo Omuria, MD
• On Angel'S Wings, Inc.
• On Pointllc
• On Sight Optical LLC
• On the Move Mobile IV and Medical, LLC

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.
• 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.