Individual provider Active NPI

Amanda Camargo Roach

  • Critical Care Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1962376103
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
1214386 Issued in TX
Practice address
6651 Main St Ste E1420
Houston, TX 77030-2432
Phone
(832) 825-6230
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 1214386 TX Primary

Addresses

Primary practice location

6651 Main St Ste E1420
Houston, TX 77030-2432

Mailing address

6651 Main St Ste E1420
Houston, TX 77030-2432
Phone (832) 825-6230

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
I20251029002489 TX Practitioner - Nurse Practitioner 8022507128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 Bates Ave
Fc1450
Houston, TX 77030-2698

PO Box
Dallas, TX 75284

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1214386TXMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Oct 17, 2025 Accepting new patients

Locations

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Ste E1420
Houston, TX 77030
Phone (832) 825-6230

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 1

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": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1962376103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 MAIN ST STE E1420",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302432",
            "telephone_number": "832-825-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 MAIN ST STE E1420",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302432",
            "telephone_number": "832-825-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "AMANDA",
        "middle_name": "CAMARGO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "TX",
            "license": "1214386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.