Individual provider Active NPI

Anastasia Kiimu Kimanthi

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1801523485
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1076084 Issued in TX
Practice address
3840 Hulen St
Fort Worth, TX 76107-7277
Phone
(817) 335-3022
NPI assigned
Aug 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1076084 TX Primary

Addresses

Primary practice location

3840 Hulen St
Fort Worth, TX 76107-7277

Mailing address

PO Box 2603
Fort Worth, TX 76113-2603

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
I20231104000340 TX Practitioner - Nurse Practitioner 4082061569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Health My Resources of Tarrant CountyGroup PAC ID 6406755693, 44 clinicians

Practice addresses (Care Compare)

3840 Hulen St
Fort Worth, TX 76107-7277
Phone (817) 569-4300

Merit-based Incentive Payment System (MIPS)

Final score
76.69 of 100Reported as group
Quality
57.54
Promoting interoperability
51
Improvement activities
40
Cost
88.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1076084TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Health My Resources of Tarrant County Psychiatry CurrentSince Oct 30, 2023 Accepting new patients
My Health My Resources of Tarrant County Past Accepting new patients

Locations

3840 Hulen St
Ft Worth, TX 76107
Phone (817) 569-4395

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1801523485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2603",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-335-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMANTHI",
        "first_name": "ANASTASIA",
        "middle_name": "KIIMU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1076084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.