Individual provider Active NPI

Mitsi Darlene Pimentel, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1972040798
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133528 Issued in TX
Practice address
4701 Boat Club Rd., Suite 200
Fort Worth, TX 76135-5285
Phone
(817) 237-0515
NPI assigned
Jan 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP133528 TX Primary

Addresses

Primary practice location

4701 Boat Club Rd., Suite 200
Fort Worth, TX 76135-5285

Mailing address

4701 Boat Club Rd., Suite 200
Fort Worth, TX 76135-5285
Phone (817) 237-0515

Other names 1

  • Mrs. Mitsi Guest Pimentel Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpimentel1305065@Direct.TexasHealth.org 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
I20180405002335 TX Practitioner - Nurse Practitioner 2466715370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

4701 Boat Club Rd
Suite 200
Fort Worth, TX 76135-5285
Phone (817) 237-0515

Hospital & facility affiliations

  • Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 1, 2018 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2018 Accepting new patients
Texas Health Physicians Group Current Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4701 Boat Club Rd
Ste 125
Fort Worth, TX 76135
Phone (817) 237-0515

4504 Boat Club Rd
Ste 800
Ft Worth, TX 76135
Phone (817) 237-0515

4701 Boat Club Rd
Ste 200
Ft Worth, TX 76135
Phone (817) 237-0515

Interoperability endpoints

  • Direct secure messaging: mpimentel1305065@direct.texashealth.org

Organizations & group practices 3

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.

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": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972040798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 BOAT CLUB RD., SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761355285",
            "telephone_number": "817-237-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 BOAT CLUB RD., SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761355285",
            "telephone_number": "817-237-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTEL",
        "first_name": "MITSI",
        "middle_name": "DARLENE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpimentel1305065@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "health information exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4701 Boat Club Rd., Suite 200",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761355285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MITSI",
            "last_name": "PIMENTEL",
            "middle_name": "GUEST",
            "prefix": "MRS.",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.