Igor Wanko Mboumi, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01082242A Issued in IN

Practice address

5255 E Stop 11 Rd Ste 450
Indianapolis, IN 46237-6342

Phone

(317) 865-4800

Fax

(317) 865-4806

NPI assigned

May 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

General Surgery

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
• Franciscan Health Mooresville Hospital, Mooresville, IN, CCN 150057

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iwankomboumi408705@direct.franciscanalliance.org

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.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment Care Compare group NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Mooresville, IN
  • NPI 1679678197
  Care Compare affiliation

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1225473929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 E STOP 11 RD STE 450",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462376342",
            "telephone_number": "317-865-4800",
            "fax_number": "317-865-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6075 Croix Dr",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "WI",
            "postal_code": "53719",
            "country_code": "US",
            "telephone_number": "240-478-5916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6075 Croix Dr",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "WI",
            "postal_code": "53719",
            "country_code": "US",
            "telephone_number": "240-478-5916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANKO MBOUMI",
        "first_name": "IGOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "68807",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01082242A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iwankomboumi408705@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5255 E Stop 11 Rd Ste 450",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yan Min Wang, MT
• Yifei Wang
• Yun Wang, NP
• Yunwei Wang, M.D., PH.D
• Joy V Wanjiru
• Taryn Wanninger, LCSW
• Abigail Wantz
• Bradley Wantz, LCSW
• Tehaam Waraich, DO
• Warby Parker Inc.

• Surgery Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.