Individual provider Active NPI

Caroline N Mbugua

  • Gerontology Nurse Practitioner
  • Newark, DE
National Provider Identifier
1174398945
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
LP-0010658 Issued in DE
Practice address
4 Peddlers Row Unit 391
Newark, DE 19702-1525
Phone
(617) 365-2164
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X LP-0010658 DE Primary

Addresses

Primary practice location

4 Peddlers Row Unit 391
Newark, DE 19702-1525

Mailing address

157 Tuckahoe LN
Newark, DE 19702
Phone (617) 365-2164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240229002787 DE Practitioner - Nurse Practitioner 2365887379 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Post Acute Medical Services 1Group PAC ID 2466727755, 34 clinicians
De Pacs 2 PAGroup PAC ID 0244580926, 26 clinicians

Practice addresses (Care Compare)

200 E Village Rd
Newark, DE 19713-3845
Phone (302) 366-8100

255 Possum Park Rd
Newark, DE 19711-3877
Phone (302) 366-0160

700 Foulk Rd
Wilmington, DE 19803-3708
Phone (302) 764-0181

810 S Broom St
Wilmington, DE 19805-4245
Phone (302) 652-1181

924 Barksdale Rd
Newark, DE 19711-3213
Phone (302) 455-7979

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LP-0010658DEMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Post Acute Medical Services 1 CurrentSince Sep 3, 2024 Accepting new patients
Geriatric Medicine Consultants PA CurrentSince Dec 24, 2023 Accepting new patients
CS Pacs 3 Northeast, LLC CurrentSince Jan 1, 2025 Accepting new patients
Kisima Healthcare LLC Gerontology CurrentSince Jan 1, 2026 Accepting new patients
De Pacs 2 PA CurrentSince Sep 3, 2024 Accepting new patients

Locations

4 Peddlers Row
Newark, DE 19702
Phone (302) 310-7998

810 S Broom St
Wilmington, DE 19805
Phone (302) 234-5420

1601 Milltown Rd
Ste 2
Wilmington, DE 19808
Phone (302) 463-6542

700 Foulk Rd
Wilmington, DE 19803
Phone (302) 328-1582

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1174398945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 TUCKAHOE LN",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19702",
            "telephone_number": "617-365-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PEDDLERS ROW UNIT 391",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197021525",
            "telephone_number": "617-365-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBUGUA",
        "first_name": "CAROLINE",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DE",
            "license": "LP-0010658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.