Individual provider Active NPI

Mercy Ngeusang, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1891310009
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP145902 Issued in TX
Practice address
5440 Tuxbury Pond Dr
Fort Worth, TX 76179-1489
Phone
(240) 605-4672
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP145902 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP145902 TX Primary

Addresses

Primary practice location

5440 Tuxbury Pond Dr
Fort Worth, TX 76179-1489

Mailing address

5440 Tuxbury Pond Dr
Fort Worth, TX 76179-1489
Phone (240) 605-4672

Other identifiers 1

IdentifierTypeStateIssuer
AP145902OtherTXTEXAS BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210716001833 OR Practitioner - Nurse Practitioner 9335541069 Reassigns benefits to 1 organization
I20230106002438 WA Practitioner - Nurse Practitioner 9335541069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Services for Wellbeing, Inc.Group PAC ID 2163641598, 29 clinicians

Practice addresses (Care Compare)

15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3071
Phone (206) 242-8211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145902TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services for Wellbeing, Inc. CurrentSince Dec 27, 2022 Accepting new patients
Tuality Healthcare Current Accepting new patients
Tuality Medical Group LLC CurrentSince Jun 3, 2021 Accepting new patients
Tuality Medical Group LLC CurrentSince Jun 3, 2021 Accepting new patients

Locations

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

15811 Ambaum Blvd SW
Ste 110
Burien, WA 98166
Phone (206) 242-8211

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1891310009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 TUXBURY POND DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761791489",
            "telephone_number": "240-605-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 TUXBURY POND DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761791489",
            "telephone_number": "240-605-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGEUSANG",
        "first_name": "MERCY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP145902",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP145902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.