Individual provider Active NPI

Mariana Ontiveros, APRN

  • Primary Care Nurse Practitioner
  • Live Oak, TX
National Provider Identifier
1912696493
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1114788 Issued in TX
Practice address
12410 Toepperwein Rd
Live Oak, TX 78233-3230
Phone
(210) 742-6555
NPI assigned
May 2, 2023
Last updated
May 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1114788 TX Primary

Addresses

Primary practice location

12410 Toepperwein Rd
Live Oak, TX 78233-3230

Mailing address

12410 Toepperwein Rd
Live Oak, TX 78233-3230
Phone (210) 742-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 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
I20231011001589 TX Practitioner - Nurse Practitioner 1759736739 Reassigns benefits to 1 organization
I20260320003205 CA Practitioner - Nurse Practitioner 1759736739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Onclick Healthcare IncorporatedGroup PAC ID 9830511260, 63 clinicians

Practice addresses (Care Compare)

Imperial Beach, CA 91932
Phone (818) 230-2116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1114788TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heal Well Primary Care PC CurrentSince May 1, 2023 Accepting new patients
Hillside Primary Care PLLC CurrentSince May 1, 2023 Accepting new patients
Complete Care Partners LLC Past Accepting new patients

Locations

11671 Jollyville Rd
Ste 102
Austin, TX 78759
Phone (210) 463-4000

12410 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 659-4425

12410 Toepperwein Rd
#O
Live Oak, TX 78233
Phone (210) 659-4425

12881 N Interstate 35
Live Oak, TX 78233
Phone (210) 742-6552

12881 Toepperwein Rd
#I35
Live Oak, TX 78233

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, 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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1912696493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONTIVEROS",
        "first_name": "MARIANA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1114788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.