Individual provider Active NPI

Abiodun M Ambali, APRN

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1831764703
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1045872 Issued in TX
Practice address
7500 Beechnut St # Xa
Houston, TX 77074-4335
Phone
(713) 448-7171
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 851905 TX
Gerontology Nurse Practitioner 363LG0600X 1045872 TX Primary

Addresses

Primary practice location

7500 Beechnut St # Xa
Houston, TX 77074-4335

Mailing address

18220 State Highway 249
Houston, TX 77070-4347
Phone (281) 737-1569

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
I20230824002449 TX Practitioner - Nurse Practitioner 9931562808 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5900 Balcones Dr
Suite 100
Austin, TX 78731-4298
Phone (832) 521-8647

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
851905TXMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Core Care Health LLC Gerontology CurrentSince Sep 28, 2024 Accepting new patients
Aman Ali Jafar, MD., PA CurrentSince Aug 8, 2023 Accepting new patients

Locations

5900 Balcones Dr
Ste 100
Austin, TX 78731

1708 Spring Green Blvd
Ste 120
Katy, TX 77494
Phone (713) 566-1999

3531 Town Center Blvd S
Sugar Land, TX 77479
Phone (281) 491-3225

3531 Town Center Blvd S
Ste 101
Sugar Land, TX 77479
Phone (281) 491-3225

Interoperability endpoints

  • Direct secure messaging: abiodun.ambali.2@28492.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1831764703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18220 STATE HIGHWAY 249",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770704347",
            "telephone_number": "281-737-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BEECHNUT ST # XA",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770744335",
            "telephone_number": "713-448-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBALI",
        "first_name": "ABIODUN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "851905",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1045872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.