Sopa Mahaboonpachai, APRN/FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1013544 Issued in TX

Practice address

7709 San Jacinto PL Ste 100
Plano, TX 75024-3369

Phone

(972) 491-1200

Fax

(469) 208-4641

NPI assigned

Dec 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Wound Care and Hyperbaric Specialists of TexasGroup PAC ID 4981865888, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
• Select Specialty Hospital-Dallas Long-term care hospital, Plano, TX, CCN 452022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Advance Wound Care & Hyperbaric Specialists of Texas

  • Wound Care Registered Nurse
  • Plano, TX
  • NPI 1083983407
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Regional Medical Center at Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1649273434
  Care Compare affiliation
• Select Specialty Hospital Dallas Inc

  • Long Term Care Hospital
  • Plano, TX
  • NPI 1063411239

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1912593252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 PORTRAIT LN",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243847",
            "telephone_number": "972-212-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7709 SAN JACINTO PL STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243369",
            "telephone_number": "972-491-1200",
            "fax_number": "469-208-4641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9229 Lebanon Rd",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750356065",
            "country_code": "US",
            "telephone_number": "469-789-2595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHABOONPACHAI",
        "first_name": "SOPA",
        "name_prefix": "Mrs.",
        "credential": "APRN/FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1013544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Plano",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange (HIE)",
            "address_1": "7709 San Jacinto Pl Ste 100",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750243369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Victoria Magana
• Jamie Tais Magana
• Halle Jo Magee, PA-C
• Magnolia Assisted Living and Memory Care LLC
• Magnum Billing Services
• Tammy J Mahan, LPC
• Bahareh Mahdavi
• Mahmood R Khan MD PA
• Alia Mahmood
• Sammy Mohamed Mahmoud, MS, DDS

• Family Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.