Individual provider Active NPI

Mukuka Mukupo Mumbi

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1003305558
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP135824 Issued in TX
Practice address
921 Gessner Rd
Houston, TX 77024-2501
Phone
(737) 205-5084
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP135824 TX Primary

Addresses

Primary practice location

921 Gessner Rd
Houston, TX 77024-2501

Mailing address

17307 Sandalisle LN
Richmond, TX 77407-2634
Phone (832) 628-5274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724002394 TX Practitioner - Nurse Practitioner 8022365931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

921 Gessner Rd
Houston, TX 77024-2501

Hospital & facility affiliations

  • Memorial Hermann Memorial City Hospital Hospital, Houston, TX, CCN 450610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP135824TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC CurrentSince Aug 7, 2018 Accepting new patients
Memorial Hermann Medical Group CurrentSince Sep 9, 2019 Accepting new patients

Locations

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1003305558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17307 SANDALISLE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072634",
            "telephone_number": "832-628-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GESSNER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242501",
            "telephone_number": "737-205-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMBI",
        "first_name": "MUKUKA",
        "middle_name": "MUKUPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP135824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.