Individual provider Active NPI

Pauline Mopur, FNP-C

  • Family Nurse Practitioner
  • Lufkin, TX
National Provider Identifier
1801331624
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
770059 Issued in TX
Practice address
501 Crown Colony Dr
Lufkin, TX 75901-7715
Phone
(224) 622-1673
NPI assigned
Jan 3, 2017
Last updated
Jan 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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 770059 TX Primary

Addresses

Primary practice location

501 Crown Colony Dr
Lufkin, TX 75901-7715

Mailing address

501 Crown Colony Dr
Lufkin, TX 75901-7715
Phone (224) 622-1673

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
I20170424002334 TX Practitioner - Nurse Practitioner 8325324577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Center of Southeast TexasGroup PAC ID 9739195041, 18 clinicians

Practice addresses (Care Compare)

204 W Park
Livingston, TX 77351-9336
Phone (936) 327-4660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
770059TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Center of Southeast Texas Family CurrentSince Mar 13, 2017 Accepting new patients
Health Center of Southeast Texas Current Accepting new patients
Health Center of Southeast Texas Family CurrentSince Mar 13, 2017 Accepting new patients

Locations

307 N William Barnett Ave
Cleveland, TX 77327
Phone (281) 592-2224

1400 N Travis St
Liberty, TX 77575
Phone (936) 327-4660

204 W Park
Livingston, TX 77352
Phone (936) 327-4660

204 W Park
Ste 200
Livingston, TX 77352
Phone (936) 327-4660

11 Woodland Park Dr
Shepherd, TX 77371
Phone (936) 628-1100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIDFAA
  • Direct secure messaging: paulinenp.mopur@hcost.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1801331624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CROWN COLONY DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017715",
            "telephone_number": "224-622-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CROWN COLONY DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017715",
            "telephone_number": "224-622-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOPUR",
        "first_name": "PAULINE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "770059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.