MONA LISA JIMENEZ (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1043828544
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MONA LISA JIMENEZ (PMHNP-BC)
400 N WALL ST STE B402
KANKAKEE, IL 609012940
Phone: (815) 937-1237
Fax: (815) 933-0662
Type: Mailing
431 E STATE HIGHWAY 114 FL 1
SOUTHLAKE, TX 760924412
Phone: (844) 824-8775
Type: Location
1425 Greenway Dr
Irving, TX 750382447
Phone: (817) 751-7802
Fax: (817) 751-7802
Type: Location
1425 GREENWAY DR
IRVING, TX 750382447
Phone: (817) 751-7802
Fax: (817) 751-7802
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: 2022-05-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220519000212 | I | Nurse Practitioner | TX | TBD |
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.
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 60901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | TX | |
| P S Y C H I A T R Y | NY | |
| Clinical Social Worker | TX | |
| Mental Health Counselor | TX | |
| Mental Health Counselor | TX | |
| Mental Health Counselor | TX | |
| P S Y C H I A T R Y | TX | |
| Clinical Psychologist | TX | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | TX |
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