EDOGHOGHO STACY EDOSONMWAN RN
NPI 1356808901
Nurse Practitioner - Psychiatric/Mental Health in Fort Worth, TX
About Edoghogho Stacy Edosonmwan Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDOGHOGHO STACY EDOSONMWAN RN (NPI 1356808901) is an individual psychiatric/mental health provider in Fort Worth, Texas, licensed in Texas (1116542) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Waxahachie, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
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
Edoghogho Stacy Edosonmwan Rn 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
4Medicare enrollment records show Edoghogho Edosonmwan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
Fort Worth, TX 76133
- Reassigned Medicare billing, Texas enrollment
- 3 clinicians in this Medicare group
Dallas, TX 75211
- Reassigned Medicare billing, Texas enrollment
- 173 clinicians in this Medicare group
Lake Charles, LA 70605
- Reassigned Medicare billing, Louisiana enrollment
- 34 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 76104 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76104
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 Edoghogho Edosonmwan's NPI number?
The NPI number for Edoghogho Edosonmwan is 1356808901. It was assigned to this individual provider in the NPPES registry on March 1, 2019.
Where is Edoghogho Edosonmwan located?
Edoghogho Edosonmwan practices at 1428 E Arlington Ave, Fort Worth, TX 76104. The listed phone number is (469) 442-9930.
What is Edoghogho Edosonmwan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Edoghogho Edosonmwan enrolled in Medicare?
Yes. Edoghogho Edosonmwan 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 Edoghogho Edosonmwan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Edoghogho Edosonmwan reassigns Medicare benefits to 4 organizations: Progressive Pathways Psychiatry PLLC (Fort Worth, TX), Nasa Psychiatric Care LLC (Fort Worth, TX), Dallas County Mental Health & Mental Retardation Center (Dallas, TX) and Swla Center For Health Services (Lake Charles, LA). 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 Edoghogho Edosonmwan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Edoghogho Edosonmwan 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 8 other insurers list Edoghogho Edosonmwan 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 Edoghogho Edosonmwan was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 50 days 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.
# Edoghogho Stacy Edosonmwan, RN · NPI 1356808901
Psychiatric/Mental Health physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since March 1, 2019.
## Identity
- **NPI:** 1356808901 (Entity type: Individual)
- **Enumerated:** March 1, 2019
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 1116542 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 1428 E ARLINGTON AVE, Fort Worth, TX 76104-6124
- **Phone:** (469) 442-9930
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Progressive Pathways Psychiatry PLLC (NPI 1285479238, Fort Worth, TX); Nasa Psychiatric Care LLC (NPI 1508652140, Fort Worth, TX); Dallas County Mental Health & Mental Retardation Center (NPI 1023239886, Dallas, TX); Swla Center For Health Services (NPI 1255000675, Lake Charles, LA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** September 3, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1356808901) · Data from the CMS NPPES public registry.