Active NPI 1003009580 Individual Practitioner Female Practitioner

Mimi Song Idicula , NP

Nurse Practitioner • Irving, TX

Professional Overview & Biography Verified Profile Summary

Mimi Idicula, NP is a registered healthcare professional specializing in Nurse Practitioner in Irving, TX. Practice services are available at 6161 N STATE HIGHWAY 161 under active NPI credentials.

Frequently performed procedures and clinical services include device supply with scheduled recording and transmission for remote monitoring of musculoskeletal system, per 30 days, remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first, face-to-face behavioral counseling for obesity. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6161 N State Highway 161

Irving, TX 750382220

Telephone 9722587499

Fax 9722570897

Associated Practice Facility / Clinic

🏢 Healthcare Associates Of Irving Facility NPI 1073712329

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Irving, TX

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 11.0 Yrs

State Avg: 9.7 Yrs

Regional Practice Density

34 Specialists

Practicing in Irving, TX (4894 Statewide)

Telehealth Adoption Rate

11.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

81.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
98977 Device supply with scheduled recording and transmission for remote monitoring of musculoskeletal system, per 30 days	68	13	$170.00	$39.65
98980 Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month	63	11	$300.00	$42.42
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	56	16	$118.00	$20.60
80307 Testing for presence of drug, by chemistry analyzers	48	36	$305.00	$58.65
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms	48	36	$560.00	$107.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	336	14	$95.00	$20.63
97032 Application of electrical stimulation with therapist present, each 15 minutes	68	11	$55.00	$9.89
80307 Testing for presence of drug, by chemistry analyzers	45	34	$311.56	$60.90
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms	45	34	$603.11	$112.14
99213 Established patient office or other outpatient visit, typically 15 minutes	33	26	$236.82	$76.58
98980 Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month	24	14	$300.00	$41.74
98977 Device supply with scheduled recording and transmission for remote monitoring of musculoskeletal system, per 30 days	23	13	$226.52	$42.58
98981 Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, each additional 20 minutes per calendar month	18	11	$277.33	$33.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	17	$375.00	$108.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	4,187	88	$95.00	$21.06
97032 Application of electrical stimulation with therapist present, each 15 minutes	812	77	$55.00	$10.14
99213 Established patient office or other outpatient visit, typically 15 minutes	242	90	$215.00	$77.97
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	84	13	$95.00	$28.55
97140 Therapy procedure using manual technique, each 15 minutes	44	22	$90.00	$18.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	2,824	101	$95.00	$21.47
97032 Application of electrical stimulation with therapist present, each 15 minutes	458	67	$55.00	$10.35
99213 Established patient office or other outpatient visit, typically 15 minutes	184	85	$215.00	$79.10
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	88	16	$95.00	$27.44
97140 Therapy procedure using manual technique, each 15 minutes	45	21	$90.00	$18.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	2,365	86	$95.00	$21.95
97032 Application of electrical stimulation with therapist present, each 15 minutes	180	38	$55.00	$10.26
99213 Established patient office or other outpatient visit, typically 15 minutes	159	78	$215.00	$64.82
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	117	15	$95.00	$28.10
97140 Therapy procedure using manual technique, each 15 minutes	49	16	$90.00	$18.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	2,904	88	$95.00	$21.37
97032 Application of electrical stimulation with therapist present, each 15 minutes	460	70	$55.00	$10.30
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	214	33	$95.00	$29.81
99213 Established patient office or other outpatient visit, typically 15 minutes	172	68	$215.00	$63.32
97140 Therapy procedure using manual technique, each 15 minutes	77	23	$90.00	$18.84
97116 Walking training to 1 or more areas, each 15 minutes	53	14	$85.00	$20.15
97535 Training for self-care or home management, each 15 minutes	15	12	$100.00	$29.47

Medical Specialties & State Licenses

CMS Verified: 2021-04-15

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License TX AP137449

(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.

Chiropractor

NUCC Taxonomy Code: 111N00000X

State License TX 10049

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Nurse Practitioner

AP137449 (TX)

Secondary Practice Locations

1717 W University Dr, #408

Mckinney, TX 75069

Phone: 9725482600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

28 Associated Practitioners

Abigail Soto , PA-C

Physician Assistant - Medical

NPI 1043458631

Physician Assistant (Certified)

Dr. Maria Biard , MD

Family Medicine

NPI 1073589586

Doctor of Medicine (M.D.)

Dr. Mary Ward , DO

Family Medicine

NPI 1083687206

Doctor of Osteopathic Medicine (D.O.)

Dr. Leonard Gross , MD

Radiology - Diagnostic Radiology

NPI 1124094255

Doctor of Medicine (M.D.)

Tania Castleman , FNP-BC

Nurse Practitioner - Family

NPI 1124629639

Family Nurse Practitioner (Board Certified)

Dr. James Anderson , MD

Family Medicine

NPI 1225004351

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events

📍

Updated Practice Location July 13, 2021

Registered at 6161 N STATE HIGHWAY 161, IRVING, TX 750382220 (Tel: 9722587499)

📍

Updated Practice Location August 24, 2018

Registered at 1717 W UNIVERSITY DR, #408, MCKINNEY, TX 75069 (Tel: 9725482600)

📍

Updated Business Mailing Address August 24, 2018

Registered at 6161 N STATE HIGHWAY 161, IRVING, TX 750382220 (Tel: 9722587499)

📍

Updated Practice Location June 21, 2018

Registered at 1110 COTTONWOOD LN STE 200, IRVING, TX 75038 (Tel: 9722587499)

📍

Updated Business Mailing Address June 21, 2018

Registered at 1110 COTTONWOOD LN STE L100, IRVING, TX 750386101 (Tel: 9722587499)

👤

Provider Name / Credentials Updated June 21, 2018

Recorded as MIMI IDICULA, NP

✅

NPI Profile Active September 30, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location September 30, 2008

Registered at 1717 W UNIVERSITY DR, #408, MCKINNEY, TX 750693218 (Tel: 9725482600)

📍

Updated Business Mailing Address September 30, 2008

Registered at 1717 W UNIVERSITY DR, #408, MCKINNEY, TX 750693218 (Tel: 9725482600)

👤

Provider Name / Credentials Updated September 30, 2008

Recorded as MIMI SONG, DC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 30, 2008

Chiropractor (License #10049 in TX)

🟢

Initial NPI Registration & Enumeration August 20, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1003009580

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 20, 2007

Last Update: July 13, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

6161 N State Highway 161

Irving, TX 750382220

Phone: 9722587499

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.