MISPA EWUBE NKONGHO (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1083389662
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,209 NURSE PRACTITIONER in TX
Provider Addresses for MISPA EWUBE NKONGHO (NP)
2212 BALD EAGLE WAY
GRAND PRAIRIE, TX 750524138
Phone: (214) 900-2529
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)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-03-22 • Largest payer in this snapshot: ABBVIE INC. ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $18 |
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: 2025-05-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20211109003392 | I | Nurse Practitioner | AZ | TBD |
| I20230718001186 | I | Nurse Practitioner | NM | TBD |
| I20250502001715 | I | Nurse Practitioner | CO | 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 |
|---|---|---|---|---|
| Q3014 | Telehealth originating site facility fee | 54 | 28 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 40 | 25 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 39 | 29 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 20 | 20 | $0 |
Insurance plans in this area (ZIP 75052)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | WA | |
| - | AZ | |
| P S Y C H I A T R Y | AZ | |
| - | NE | |
| Internal Medicine | AZ | |
| P S Y C H I A T R Y | AZ |
Reviews
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