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PERIS B MOMANYI
NPI 1194533356
Nurse Practitioner - Family in Grand Prairie, TX

Active since December 20, 2024PECOS EnrolledAccepts Medicare Assignment
3531 PONDEROSA DR, GRAND PRAIRIE, TX 75052(469) 358-9331 Get Directions Write a Review

NPPES record last updated: December 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Peris B Momanyi NPPES

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

PERIS B MOMANYI (NPI 1194533356) is an individual family provider in Grand Prairie, Texas, licensed in Texas (1177246) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1194533356
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NamePERIS B MOMANYI
Location Address3531 PONDEROSA DRGrand Prairie, TX 75052-7858
Mailing Address3531 Ponderosa DrGrand Prairie, TX 75052-7858
Phone(469) 358-9331
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateDecember 20, 2024
NPPES CertifiedDecember 20, 2024
✔ NPI 1194533356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 1177246
3531 PONDEROSA DR, Grand Prairie, TX 75052
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Peris B Momanyi 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 ID5799266417
PECOS Enrollment IDI20260220002244
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.

Medicare Billing Reassignment

Medicare enrollment records show Peris Momanyi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medi- Elite, PC
13 mi
Primary Care
2721 CENTRAL DR
Bedford, TX 76021
  • Reassigned Medicare billing, Texas enrollment
  • 4 clinicians in this Medicare group
NPI 1528330792 (682) 703-8881

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75052 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.

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 Peris Momanyi's NPI number?

The NPI number for Peris Momanyi is 1194533356. It was assigned to this individual provider in the NPPES registry on December 20, 2024.

Where is Peris Momanyi located?

Peris Momanyi practices at 3531 Ponderosa Dr, Grand Prairie, TX 75052. The listed phone number is (469) 358-9331.

What is Peris Momanyi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Peris Momanyi enrolled in Medicare?

Yes. Peris Momanyi 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 organization bills Medicare for Peris Momanyi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peris Momanyi reassigns Medicare benefits to Medi- Elite, PC (Bedford, TX). The 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 Peris Momanyi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Peris Momanyi accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Peris Momanyi 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.

When was this NPI record last updated?

The NPPES record for Peris Momanyi was last updated on December 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.