Hamutyinei H Mamutse

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.026184 Issued in OH

Practice address

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Phone

(260) 483-9081

Fax

(260) 483-9196

NPI assigned

Feb 18, 2020

Last updated

Feb 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  OH

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  OH

  Medicare reassignment Care Compare group NPD
• Eventus Ecs - Ohio LLC

  • Nurse Practitioner
  • Hilliard, OH
  • NPI 1972321842
  Medicare reassignment NPD
• Harmony Mood LLC

  • Adult Mental Health Clinic/Center
  • Fairfield, OH
  • NPI 1639862253
  NPD Authorized official
• Extended Care Specialists, Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1669873733
  NPD

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1033742184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392552",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519500",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMUTSE",
        "first_name": "HAMUTYINEI",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.026184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley A Malone
• Mary M Maloney, M.D.
• Susan M. Maloney, NP-C
• Jennifer L Malott, MSW, LSCW
• Ravi Malpani
• Nisreen Manago
• Sylvia A Manalis, MD
• Edna M Manalo, PA
• John Paul Magno Manalo, M.D.
• Manolo M. Manalo, MD

• Psychiatric/Mental Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.