MIMI T AKABA (FNP) – Nurse Practitioner, NPI 1851472021

MIMI T AKABA (FNP) is a healthcare provider. based in Fremont, California. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. NP13613 (CA). The NPI Number for MIMI T AKABA (FNP) is 1851472021

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MIMI T AKABA (FNP)
NPI
1851472021
Phone
(570) 770-8133
Address
39500 Liberty Street
Enumeration Date
17 October 2006
Last Update Date
11 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4088855000
Graduation Year
2002 (24 years ago)
PAC ID
5092812644
Group Practice PAC ID
1254244973
Professional Enrollment ID
I20070516000530
Address ID
CA951282604SA751XXAVEX449
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

16,353 NURSE PRACTITIONER in CA

Provider Addresses for MIMI T AKABA (FNP)

  • 39500 Liberty Street

    Tri City Health Center

    Fremont, CA 94538

    Phone: (570) 770-8133

    Fax: (570) 770-8140

    Type: Location

  • 325, Distel Circle, Los Altos, Santa Clara County, California, 94022, United States

    LOS ALTOS, CA 940221408

    Phone: (925) 875-6100

    Type: Mailing

  • 4050, Dublin Boulevard, Dublin, Alameda County, California, 9458811, United States

    DUBLIN, CA 945683112

    Phone: (925) 875-6100

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070516000530INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94538)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254244973View full group profile
NameSpecialtyState
-CA
Clinical PsychologistCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
-CA
Internal Medicine, Critical Care (Intensivists), Pulmonary DiseaseCA
Nurse PractitionerCA
Internal Medicine, HospitalistPA
-CA
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

What is the registry number for MIMI T AKABA (FNP)?
The registry entry for MIMI T AKABA (FNP) shows NPI 1851472021.
Is MIMI T AKABA (FNP)'s NPI status active today?
Active status means MIMI T AKABA (FNP)'s NPI record is not deactivated in the public file.
What type of care does MIMI T AKABA (FNP) provide?
MIMI T AKABA (FNP)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to MIMI T AKABA (FNP)?
The directory associates MIMI T AKABA (FNP) with Fremont, California. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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