Individual provider Active NPI

Romaric Bantumbakulu Mukuna, MD

  • Internal Medicine Physician
  • Evansville, IN
National Provider Identifier
1043913437
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01100943A Issued in IN
Practice address
801 Saint Marys Dr Ste 510
Evansville, IN 47714-0511
Phone
(812) 485-4422
NPI assigned
Mar 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01100943A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X IN

Addresses

Primary practice location

801 Saint Marys Dr Ste 510
Evansville, IN 47714-0511

Mailing address

113 N Sea Fury LN Apt 102
Boise, ID 83704-9453
Phone (208) 850-6056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621000457 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8224496435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: romaric.mukuna.1@7598.direct.athenahealth.com
  • Direct secure messaging: rmukuna237392@direct.deaconess.com

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1043913437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N SEA FURY LN APT 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049453",
            "telephone_number": "208-850-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR STE 510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-485-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKUNA",
        "first_name": "ROMARIC",
        "middle_name": "BANTUMBAKULU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01100943A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.