Individual provider Active NPI

Aji Anta Deen, FNP-C

  • Family Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1871335125
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1066529 Issued in TX
Practice address
1420 N Galloway Ave
Mesquite, TX 75149-2326
Phone
(972) 285-6703
Fax
(972) 285-3966
NPI assigned
Jun 8, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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 1066529 TX Primary

Addresses

Primary practice location

1420 N Galloway Ave
Mesquite, TX 75149-2326

Mailing address

1420 N Galloway Ave
Mesquite, TX 75149-2326
Phone (972) 285-6703

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
I20241028003896 TX Practitioner - Nurse Practitioner 9739612839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenerative Medicine of Texas PLLCGroup PAC ID 1254660434, 5 clinicians

Practice addresses (Care Compare)

1420 N Galloway Ave
Suite B
Mesquite, TX 75149-2326
Phone (972) 285-6703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1066529TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mesquite Chiropractic Health Center CurrentSince Oct 6, 2024 Accepting new patients
Regenerative Medicine of Texas, PLLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

1420 N Galloway Ave
Mesquite, TX 75149
Phone (972) 285-6703

1420 N Galloway Ave
Ste B
Mesquite, TX 75149
Phone (972) 285-6703

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, 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": "1717804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1871335125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492326",
            "telephone_number": "972-285-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492326",
            "telephone_number": "972-285-6703",
            "fax_number": "972-285-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEN",
        "first_name": "AJI",
        "middle_name": "ANTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-08",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1066529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.