Individual provider Active NPI

Maribel R Hinojosa, PHD

  • Clinical Psychologist
  • College Station, TX
National Provider Identifier
1821158353
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33162 Issued in TX
Practice address
750 William D Fitch Pkwy Ste 520
College Station, TX 77845-7494
Phone
(979) 335-9199
Fax
(979) 232-2176
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 5038 TX
Clinical Psychologist 103TC0700X 33162 TX Primary

Addresses

Primary practice location

750 William D Fitch Pkwy Ste 520
College Station, TX 77845-7494

Mailing address

2172 Chestnut Oak Cir
College Station, TX 77845-4168
Phone (979) 324-7931

Other identifiers 3

IdentifierTypeStateIssuer
0083QYOtherTXBC/BS OF TEXAS
149909703MedicaidTX
612701OtherTXMEDICARE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070327000073 TX Practitioner - Clinical Psychologist 7719081025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

750 William D Fitch Pkwy
Suite 520
College Station, TX 77845-7494
Phone (979) 335-9199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5038TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Psychological PLLC Clinical CurrentSince Nov 22, 2019 Accepting new patients
St. Thomas Medical Group PLLC Past Accepting new patients
Pinkerman & Gonzalez Psychological Clinical Past Accepting new patients
RGV Senior Care, PC Clinical Past Accepting new patients

Locations

750 William D Fitch Pkwy
Ste 520
College Station, TX 77845
Phone (979) 335-9199

Interoperability endpoints

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

Organizations & group practices 4

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1821158353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2172 CHESTNUT OAK CIR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454168",
            "telephone_number": "979-324-7931",
            "fax_number": "979-232-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WILLIAM D FITCH PKWY STE 520",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457494",
            "telephone_number": "979-335-9199",
            "fax_number": "979-232-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINOJOSA",
        "first_name": "MARIBEL",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "5038",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "0083QY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149909703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "612701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.