Individual provider Active NPI

Teresita Manigbas Idea, RN

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1952944654
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP143989 Issued in TX
Practice address
6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Oct 25, 2019
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP143989 TX Primary
Family Nurse Practitioner 363LF0000X AP143989 TX
Ambulatory Care Registered Nurse 163WP2201X 453710 TX

Addresses

Primary practice location

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 840853
Dallas, TX 75284-4000
Phone (972) 233-1999

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Houston Health Information Exchange (HIE)

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
I20220503001266 TX Practitioner - Nurse Practitioner 8921495342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone (713) 620-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
453710TXMDAmbulatory Care Registered Nurse
AP143989TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients

Locations

1500 Citywest Blvd
Ste 300
Houston, TX 77042
Phone (713) 458-4185

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

Interoperability endpoints

  • Direct secure messaging: tidea402132@directhoustonmethodist.org

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1952944654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844000",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDEA",
        "first_name": "TERESITA",
        "middle_name": "MANIGBAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP143989",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143989",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "453710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "endpointDescription": "primary business address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1515 Holcombe Blvd",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.