ISIMENMEN ETAKIBUEBU DNP, M.ED., APRN
NPI 1679102883
Nurse Practitioner - Psychiatric/Mental Health in Austin, TX

Q: What is Isimenmen Etakibuebu's NPI number?

The NPI number for Isimenmen Etakibuebu is 1679102883. It was assigned to this individual provider in the NPPES registry on April 8, 2020.

Q: What is Isimenmen Etakibuebu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since April 08, 2020PECOS EnrolledAccepts Medicare Assignment

1631 E 2ND ST STE D, AUSTIN, TX 78702(512) 804-3663(512) 476-1469 Get Directions Write a Review

NPPES record last updated: January 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Isimenmen Etakibuebu Dnp, M.ed., Aprn NPPES

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

ISIMENMEN ETAKIBUEBU DNP, M.ED., APRN (NPI 1679102883) is an individual psychiatric/mental health provider in Austin, Texas, licensed in Texas (1157891) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1679102883

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameISIMENMEN ETAKIBUEBUCredential: DNP, M.ED., APRN

Location Address1631 E 2ND ST STE DAustin, TX 78702-4491

Mailing Address1631 E 2nd St Ste DAustin, TX 78702-4491 · (512) 804-3663 · Fax (512) 476-1469

Phone(512) 804-3663

Fax(512) 476-1469

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateApril 8, 2020

Last NPPES UpdateJanuary 19, 2025

NPPES CertifiedJanuary 19, 2025

✔ NPI 1679102883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in TX · 1157891

Also ListedRegistered NurseTaxonomy 163W00000X · License 988738 (TX)

1631 E 2ND ST STE D, Austin, TX 78702

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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

Isimenmen Etakibuebu Dnp, M.ed., Aprn 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 ID446770846

PECOS Enrollment IDI20250227002547

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78702 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

$89.03 typical visit price

range $57.88 – $174.00

Typical copayment $22.25 (range $14.47 – $43.50)

Most-billed visit code 99203

Established Patient

$101.65 typical visit price

range $18.88 – $142.23

Typical copayment $25.41 (range $4.72 – $35.55)

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.

MEGAN A. HURLBERT LCSW

Social Worker (Clinical)