Individual provider Active NPI

Mathilde Monga Wangsi Cheuko

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1134500424
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA11265 Issued in DC
Practice address
933 52ND St NE
Washington, DC 20019-5553
Phone
(240) 409-2702
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA11265 DC Primary

Addresses

Primary practice location

933 52ND St NE
Washington, DC 20019-5553

Mailing address

933 52ND St NE
Washington, DC 20019-5553
Phone (240) 409-2702

Other identifiers 1

IdentifierTypeStateIssuer
70821077MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HHA11265DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1134500424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 52ND ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200195553",
            "telephone_number": "240-409-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 52ND ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200195553",
            "telephone_number": "240-409-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGA WANGSI CHEUKO",
        "first_name": "MATHILDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA11265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70821077",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.