Bala Michael Wambebe

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

226621 Issued in AZ

Practice address

2910 South Greenfield Road
Apt. #2085
Gilbert, AZ 85295

Phone

(915) 228-0283

NPI assigned

Jun 21, 2023

Last updated

Jun 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Bridges IncGroup PAC ID 2062699721, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: balamichael.wambebenp.p1@direct.cbridges.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Bridges, Inc.

  dba CBI - Encompass Page Integrated Health Home

  • Adult Mental Health Clinic/Center
  • Page, AZ
  • NPI 1558095315
  Medicare reassignment Care Compare group NPD
• BM Global Healthcare Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
  • NPI 1447034020
  Authorized official Same address or phone
• Community Bridges, Inc

  dba Lighthouse

  • Mental Illness Community Based Residential Treatment Facility
  • Yuma, AZ
  • NPI 1861722175
  NPD
• Community Bridges, Inc.

  dba Benson Transition Point

  • Mental Illness Community Based Residential Treatment Facility
  • Benson, AZ
  • NPI 1255900189
  NPD
• Community Bridges, Inc.

  dba Toole Outpatient Service Center

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1427596196
  NPD
• Community Bridges, Inc.

  dba Community Psychiatric Emergency Center - Outpatient

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1588348775
  NPD
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1508124488
  NPD (past)
• Safestar Psychiatric and Wellness LLC

  • Nurse Practitioner
  • McKinney, TX
  • NPI 1467231472
  NPD (past)

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1265117659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 SOUTH GREENFIELD ROAD",
            "address_2": "APT. #2085",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85295",
            "telephone_number": "915-228-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 SOUTH GREENFIELD ROAD",
            "address_2": "APT. #2085",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85295",
            "telephone_number": "915-228-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMBEBE",
        "first_name": "BALA MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "226621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walnut Vision Care Az, P.C.
• Alyssa Walrath, PA-C
• Kathleen Walsh, MT-BC, M.ED., BCBA
• Matthew Walters
• Emily Walton, MA
• Helen Huey-Li Wang
• Judy Kiang Wang, MD
• Justine Ching-Mei Wang, PA-C
• Wen Hsiu Wang, D.D.S.
• Xiaoikui Wang

• Psychiatric/Mental Health Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.