PRINCESS KUKUA AHEDOR – Psychiatric/Mental Health Nurse Practitioner, NPI 1215401906
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for PRINCESS KUKUA AHEDOR
1600 MEDICAL CENTER DR STE 400
EL PASO, TX 799025008
Phone: (915) 217-2163
Fax: (915) 217-2166
Type: Location
Rio Bravo Street, El Paso, El Paso County, Texas, 79902, United States
EL PASO, TX 799021054
Phone: (915) 532-0010
Fax: (915) 532-0012
Type: Mailing
920 N Telshor Blvd Ste E
Las Cruces, NM 880118279
Phone: (915) 955-2238
Fax: (982) 268-0069
Type: Location
4500 CARTER CREEK PKWY STE 101B
BRYAN, TX 778024464
Phone: (915) 532-0010
Fax: (979) 316-1851
Type: Mailing
2100 GEORGE DIETER DR
EL PASO, TX 799363815
Phone: (915) 955-2238
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: 2026-02-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190222002456 | I | Nurse Practitioner | TX | TBD |
| I20260227000117 | I | Nurse Practitioner | NM | 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 79902)
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