Organization Active NPI

Ubuntu Family Medicine, PLLC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1194336966
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UBUNTU FAMILY MEDICINE, PLLC
Practice address
994 New York Ave
Brooklyn, NY 11203-3883
Phone
(347) 896-5580
Fax
(347) 896-5513
NPI assigned
Aug 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Authorized official

Name
Gloria Mtomboti, MDNPI 1235124496
Title
Owner
Phone
(917) 443-3633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

994 New York Ave
Brooklyn, NY 11203-3883

Mailing address

PO Box 180208
Brooklyn, NY 11218-0208
Phone (347) 896-5580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115001531 NY Part B Supplier - Clinic/Group Practice 1153734918 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1194336966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180208",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112180208",
            "telephone_number": "347-896-5580",
            "fax_number": "347-896-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033883",
            "telephone_number": "347-896-5580",
            "fax_number": "347-896-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UBUNTU FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "MTOMBOTI",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-443-3633",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.