T'JUANIEQUA WIDEMAN AGACNP-BC
NPI 1053195982
Nurse Practitioner in Tyler, TX
About T'juaniequa Wideman Agacnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
T'JUANIEQUA WIDEMAN AGACNP-BC (NPI 1053195982) is an individual nurse practitioner in Tyler, Texas, licensed in Texas (1115976) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Christus Mother Frances Hospital, and maintains a secondary practice location in Tyler.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
T'juaniequa Wideman Agacnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show T'juaniequa Wideman reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Tyler, TX 75702
- Reassigned Medicare billing, Texas enrollment
- 2,745 clinicians in this Medicare group
Longview, TX 75601
- Reassigned Medicare billing, Texas enrollment
- 334 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Texas enrollment
- 1,246 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Christus Mother Frances Hospital
Acute Care Hospitals · Tyler, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is T'juaniequa Wideman's NPI number?
The NPI number for T'juaniequa Wideman is 1053195982. It was assigned to this individual provider in the NPPES registry on August 22, 2023.
Where is T'juaniequa Wideman located?
T'juaniequa Wideman practices at 800 E Dawson St, Tyler, TX 75701. The listed phone number is (903) 593-8441.
What is T'juaniequa Wideman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is T'juaniequa Wideman enrolled in Medicare?
Yes. T'juaniequa Wideman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for T'juaniequa Wideman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), T'juaniequa Wideman reassigns Medicare benefits to 3 organizations: Christus Trinity Clinic Texas (Tyler, TX), North Texas Physician Services, PLLC (Longview, TX) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for T'juaniequa Wideman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does T'juaniequa Wideman accept?
Health plans from Blue Cross and Blue Shield of Texas and CHRISTUS Health Plan list T'juaniequa Wideman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is T'juaniequa Wideman affiliated with any hospitals?
According to CMS data, T'juaniequa Wideman is affiliated with Christus Mother Frances Hospital.
When was this NPI record last updated?
The NPPES record for T'juaniequa Wideman was last updated on September 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# T'juaniequa Wideman, AGACNP-BC · NPI 1053195982
Nurse Practitioner physician in Tyler, Texas. Individual provider, active in the CMS NPPES registry since August 22, 2023.
## Identity
- **NPI:** 1053195982 (Entity type: Individual)
- **Enumerated:** August 22, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 1115976 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 800 E DAWSON ST, Tyler, TX 75701-2036
- **Phone:** (903) 593-8441
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Christus Trinity Clinic Texas (NPI 1285684225, Tyler, TX); North Texas Physician Services, PLLC (NPI 1992586150, Longview, TX); Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** September 22, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1053195982) · Data from the CMS NPPES public registry.