MIMI SONG IDICULA (NP) – Nurse Practitioner, NPI 1003009580
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
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Provider Addresses for MIMI SONG IDICULA (NP)
Chopsticks Asian Cafe, 1717, West University Drive, McKinney, Collin County, Texas, 75069, United States
#408
MCKINNEY, TX 75069
Phone: (972) 548-2600
Fax: (972) 548-2610
Type: Location
1717 W University Dr
#408
McKinney, TX 75069
Phone: (972) 548-2600
Fax: (972) 548-2610
Type: Location
President George Bush Turnpike, Irving, Dallas County, Texas, 75083, United States
IRVING, TX 750382220
Phone: (972) 258-7499
Fax: (972) 257-0897
Type: Mailing
6161 N STATE HIGHWAY 161
IRVING, TX 750382220
Phone: (972) 258-7499
Fax: (972) 257-0897
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 87 Open Payments records for all available years, with a total value of $1,717.
Total Amount is formed as General ($1,717) + Research ($0) + Ownership ($0) = $1,717.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: PFIZER INC. ($292).
Total Amount
$1,717
General + Research + Ownership
Payments
87
Total payment records
General Amount
$1,717
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $292 |
| Averitas Pharma Inc. | $207 |
| Collegium Pharmaceutical, Inc. | $180 |
| Abbott Laboratories | $150 |
| Bioventus LLC | $140 |
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: 2019-06-28
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 |
|---|---|---|---|---|
| I20190628000060 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 336 | 14 | $0 |
| 97032 | Application of electrical stimulation with therapist present, each 15 minutes | 68 | 11 | $0 |
| 80307 | Testing for presence of drug, by chemistry analyzers | 45 | 34 | $0 |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 45 | 34 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 33 | 26 | $0 |
Insurance plans in this area (ZIP 75069)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | TX | |
| Interventional Pain Management, Anesthesiology, Anesthesiology | TX | |
| Nurse Practitioner | TX | |
| Anesthesiology, Pain Management | TX | |
| A N E S T H E S I O L O G Y | TX | |
| Anesthesiology, Pain Management | MO | |
| Nurse Practitioner | TX | |
| Cardiovascular Disease (Cardiology) | TX | |
| Anesthesiology, Pain Management, Preventive Medicine | NJ | |
| A N E S T H E S I O L O G Y | TX |
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