Organization Active NPI

Monduta Healthcare Services LLC

  • Health Service Clinic/Center
  • Wagoner, OK
National Provider Identifier
1023804424
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MONDUTA HEALTHCARE SERVICES LLC
Doing business as
Dunamis Complete Health
Practice address
1202 W Cherokee St Ste C
Wagoner, OK 74467-4629
Phone
(918) 857-9932
NPI assigned
Apr 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Authorized official

Name
Ernest Maina, NPNPI 1740751445
Title
Owner
Phone
(918) 857-9932

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1202 W Cherokee St Ste C
Wagoner, OK 74467-4629

Mailing address

1000 W Elmira St
Broken Arrow, OK 74012-0872
Phone (918) 857-9932

Other names 2

  • Dunamis Complete Health Doing business as
  • MONDUTA HEALTHCARE SERVICES LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260305004353 OK Part B Supplier - Clinic/Group Practice 9830671023 Receives reassigned benefits from 1 practitioner
Practice locations: Wagoner, OK

National Provider Directory

National Provider Directory

Locations

1202 W Cherokee St
Wagoner, OK 74467
Phone (918) 485-4504

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1023804424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W ELMIRA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120872",
            "telephone_number": "918-857-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W CHEROKEE ST STE C",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674629",
            "telephone_number": "918-857-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONDUTA HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "MAINA",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-857-9932",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dunamis Complete Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MONDUTA HEALTHCARE SERVICES LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wagoner, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.