COLLINS O IDIEGBE (ACNP) – Acute Care Nurse Practitioner, NPI 1073940557

COLLINS O IDIEGBE (ACNP) is a healthcare provider. based in San antonio, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials ACNP. They hold a License No. 751397 (TX). The NPI Number for COLLINS O IDIEGBE (ACNP) is 1073940557

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
COLLINS O IDIEGBE (ACNP)
NPI
1073940557
Phone
(210) 614-5400
Address
4411 MEDICAL DR
Enumeration Date
30 September 2013
Last Update Date
30 September 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2145908006
Graduation Year
2013 (13 years ago)
PAC ID
6507093887
Group Practice PAC ID
8325934813
Professional Enrollment ID
I20150416000545
Address ID
TX752357709DA5200XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for COLLINS O IDIEGBE (ACNP)

  • 4411 MEDICAL DR

    300

    SAN ANTONIO, TX 782293822

    Phone: (210) 614-5400

    Fax: (210) 614-5732

    Mailing address matches the actual address.

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: 2015-04-16

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
I20150416000545INurse PractitionerTXTBD

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 78229)

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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: 8325934813View full group profile
NameSpecialtyState
-TX
-IN
Family PracticeMA
-TX
Certified Registered Nurse Anesthetist (Crna)TX
Nurse PractitionerTX
-TX
Certified Registered Nurse Anesthetist (Crna)TX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What federal number belongs to COLLINS O IDIEGBE (ACNP)?
The federal identifier for COLLINS O IDIEGBE (ACNP) is NPI 1073940557.
Is COLLINS O IDIEGBE (ACNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize COLLINS O IDIEGBE (ACNP)'s specialty in plain language?
Clinically, the directory lists COLLINS O IDIEGBE (ACNP) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place COLLINS O IDIEGBE (ACNP)?
The snapshot lists San Antonio, Texas for COLLINS O IDIEGBE (ACNP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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