Individual provider Active NPI

Marie-Pierre Mfuamba-Mukendi, PA

  • Physician Assistant
  • Utica, NY
National Provider Identifier
1114730777
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033197 Issued in NY
Practice address
1651 Oneida St
Utica, NY 13501-4866
Phone
(315) 793-7620
Fax
(844) 683-9216
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033197 NY Primary

Addresses

Primary practice location

1651 Oneida St
Utica, NY 13501-4866

Mailing address

1651 Oneida St
Utica, NY 13501-4866
Phone (315) 793-7620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250313000257 NY Practitioner - Physician Assistant 4981125440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Health, Inc.Group PAC ID 4385826585, 8 clinicians

Practice addresses (Care Compare)

2 Rubin Dr
Rushville, NY 14544-9681
Phone (585) 554-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
033197NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Health, Inc. CurrentSince Mar 17, 2025 Accepting new patients
Mosaic Health, Inc. Past Accepting new patients

Locations

1 S Washington St
Ste 300
Rochester, NY 14614
Phone (585) 325-2280

2 Rubin Dr
Rushville, NY 14544
Phone (585) 554-4400

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.

NPI Registry JSON

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1114730777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 ONEIDA ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014866",
            "telephone_number": "315-793-7620",
            "fax_number": "844-683-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ONEIDA ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014866",
            "telephone_number": "315-793-7620",
            "fax_number": "844-683-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MFUAMBA-MUKENDI",
        "first_name": "MARIE-PIERRE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.