T'JUANIEQUA WIDEMAN AGACNP-BC
NPI 1053195982
Nurse Practitioner in Tyler, TX

Active since August 22, 2023PECOS EnrolledAccepts Medicare Assignment
800 E DAWSON ST, TYLER, TX 75701(903) 593-8441 Get Directions Write a Review

NPPES record last updated: September 22, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1053195982
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameT'JUANIEQUA WIDEMANCredential: AGACNP-BC
Location Address800 E DAWSON STTyler, TX 75701-2036
Mailing Address1309 S Azalea DrTyler, TX 75701-5222 · (903) 520-4873
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 22, 2023
Last NPPES UpdateSeptember 22, 2023
NPPES CertifiedSeptember 22, 2023
NPI 1053195982 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 · 1115976
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 ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 1115976 (TX)
800 E DAWSON ST, Tyler, TX 75701

Secondary Practice Location 1

Location 1703 S Fleishel Ave Ste 4000Tyler, TX 75701-2015 · Phone (903) 606-7000

Accepted Insurance

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID3274988449
PECOS Enrollment IDI20231006003276
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

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 discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
11 services11 patients

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, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450102
Location800 East DawsonTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Physician 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.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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 20

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

Anesthesiology
800 E DAWSON ST
TYLER, TX 75701
Internal Medicine
800 E DAWSON ST
TYLER, TX 75701
Internal Medicine
800 E DAWSON ST
TYLER, TX 75701
Anesthesiology (Critical Care Medicine)
800 E DAWSON ST
TYLER, TX 75701
Emergency Medicine
800 E DAWSON ST
TYLER, TX 75701
Internal Medicine
800 E DAWSON ST
TYLER, TX 75701
Internal Medicine
800 E DAWSON ST
TYLER, TX 75701
Internal Medicine (Critical Care Medicine)
800 E DAWSON ST
TYLER, TX 75701

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.

What insurance does T'juaniequa Wideman accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and UnitedHealthcare 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 2 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.