Mimi Song Idicula, NP is a medicare enrolled "Nurse Practitioner" provider in Irving, Texas. She graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Solar Health, P.a. and her current practice location is
6161 N State Highway 161, Irving, Texas. You can reach out to her office (for appointments etc.) via phone at
(972) 258-7499.
Mimi Song Idicula is licensed to practice in Texas (license number AP137449) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003009580.
Healthcare Provider's Profile
| Full Name | Mimi Song Idicula |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 6161 N State Highway 161, Irving, Texas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mimi Song Idicula graduated from medical school in 2017
NPI Data:
- NPI Number: 1003009580
- Provider Enumeration Date: 08/20/2007
- Last Update Date: 07/13/2021
Medicare PECOS Information:
- PECOS PAC ID: 1052459120
- Enrollment ID: I20190628000060
Medical Identifiers
Medical identifiers for Mimi Song Idicula such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003009580 | NPI | - | NPPES |
| AP137449 | Other | TX | NURSE PRACTITIONER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 10049 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | AP137449 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Solar Health, P.a. | 3577625524 | 23 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mimi Song Idicula allows following entities to bill medicare on her behalf.
| Provider Name | Healthcare Associates Of Irving Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1467413625
PECOS PAC ID: 9335052489
Enrollment ID: O20031106000566 |
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| Provider Name | Solar Health, P.a. |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1376724948
PECOS PAC ID: 3577625524
Enrollment ID: O20081229000479 |
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| Provider Name | Medical Specialty Group Pllc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1205579489
PECOS PAC ID: 4183007081
Enrollment ID: O20220810000157 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mimi Song Idicula is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mimi Song Idicula, NP
6161 N State Highway 161,
Irving, TX 75038-2220
Ph: (972) 258-7499 | Mimi Song Idicula, NP
6161 N State Highway 161,
Irving, TX 75038-2220
Ph: (972) 258-7499 |
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