MIMI SONG IDICULA NP
NPI 1003009580
Nurse Practitioner in Irving, TX

Q: What is Mimi Idicula's NPI number?

The NPI number for Mimi Idicula is 1003009580. It was assigned to this individual provider in the NPPES registry on August 20, 2007.

Q: What is Mimi Idicula's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mimi Idicula was last updated on July 13, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 20, 2007PECOS Enrolled

6161 N STATE HIGHWAY 161, IRVING, TX 75038(972) 258-7499(972) 257-0897 Get Directions Write a Review

NPPES record last updated: July 13, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 13, 2021, Aug 24, 2018, Jun 21, 2018 (3 updates tracked since 2018).

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About Mimi Song Idicula Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIMI SONG IDICULA NP (NPI 1003009580) is an individual nurse practitioner in Irving, Texas, licensed in Texas (AP137449) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mckinney.

NPPES Registry Identity

NPI1003009580

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMIMI SONG IDICULACredential: NP

Location Address6161 N STATE HIGHWAY 161Irving, TX 75038-2220

Mailing Address6161 N State Highway 161Irving, TX 75038-2220 · (972) 258-7499 · Fax (972) 257-0897

Phone(972) 258-7499

Fax(972) 257-0897

Sole ProprietorNo

Enumeration DateAugust 20, 2007

Last NPPES UpdateJuly 13, 20213 updates tracked since enumeration

NPPES CertifiedApril 15, 2021

✔ NPI 1003009580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TX · AP137449

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedChiropractorTaxonomy 111N00000X · License 10049 (TX)

6161 N STATE HIGHWAY 161, Irving, TX 75038

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Secondary Practice Location 1

Location 11717 W University Dr, #408McKinney, TX 75069 · Phone (972) 548-2600 · Fax (972) 548-2610

Other Identifiers 1

OtherAP137449TX · Nurse Practitioner

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mimi Song Idicula Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Device supply with scheduled recording and transmission for remote monitoring of musculoskeletal system, per 30 days 98977

This service involves providing a device that records and transmits data about your musculoskeletal system remotely. For 30 days, it tracks your body's musculoskeletal health, allowing for timely interventions if needed. It's a non-invasive way to monitor your health continuously.

68 services13 patients

Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month 98980

Remote therapeutic monitoring treatment management services involve a healthcare professional monitoring your health data remotely. This could include vital signs or other health information. The professional will manage your treatment for the first 20 minutes each month, adjusting as necessary based on the data received.

63 services11 patients

Face-to-face behavioral counseling for obesity, 15 minutes G0447

This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.

56 services16 patients

Testing for presence of drug, by chemistry analyzers 80307

Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.

48 services36 patients

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 G0480

A definitive drug test is a detailed examination that can identify specific drugs in your system, even closely related ones. Techniques like GC/MS and LC/MS are used for high precision. This helps ensure accurate results for your safety and health.

48 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75038 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.19 typical visit price

range $57.18 – $172.86

Typical copayment $22.04 (range $14.29 – $43.21)

Most-billed visit code 99203

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY C WARD D.O.

Family Medicine