Individual provider Active NPI

Yaminiben Bhakta, PA-C

  • Physician Assistant
  • Pearland, TX
National Provider Identifier
1790290070
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12234 Shadow Creek Pkwy Ste 4104
Pearland, TX 77584
Phone
(713) 429-5325
NPI assigned
Dec 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

12234 Shadow Creek Pkwy Ste 4104
Pearland, TX 77584

Mailing address

12234 Shadow Creek Pkwy Ste 4104
Pearland, TX 77584-7333
Phone (713) 429-5325

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
I20180327001288 TX Practitioner - Physician Assistant 8527320845 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center Physician Assistant CurrentSince Jan 7, 2019 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Jan 7, 2019 Accepting new patients
Texas Behavioral Health PLLC PastSince Jul 15, 2016 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEBFAD

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": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1790290070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12234 SHADOW CREEK PKWY STE 4104",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847333",
            "telephone_number": "713-429-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12234 SHADOW CREEK PKWY STE 4104",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77584",
            "telephone_number": "713-429-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "YAMINIBEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.