NPIMap

Individual provider Active NPI

Mbu Mongwa, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Urbana, IL
National Provider Identifier
1295947083
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036123786 Issued in IL
Practice address
611 W Park St
Cardiology
Urbana, IL 61801-2529
Phone
(217) 904-7000
Fax
(217) 904-7742
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 056321 GA
Internal Medicine Physician 207R00000X 225666 NY
Internal Medicine Physician 207R00000X 036123786 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036123786 IL Primary

Addresses

Primary practice location

611 W Park St
Cardiology
Urbana, IL 61801-2529

Mailing address

611 W Park St
BWPC
Urbana, IL 61801-2529
Phone (217) 383-6792

Other identifiers 2

IdentifierTypeStateIssuer
P00753211OtherRAILROAD
036123786MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000450 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 2264480748 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care Incorporated 1,592 clinicians
Hoopeston Community Memorial Hospital 142 clinicians

Practice addresses (Care Compare)

100 Lerna S Rd
Mattoon, IL 61938-9384
Phone (217) 258-5900

1001 Heather Dr
Mahomet, IL 61853-2754
Phone (217) 586-8444

1002 Medical Ctr Dr
Monticello, IL 61856-2116
Phone (217) 762-2518

1540 E Grove Ave
Rantoul, IL 61866-2736
Phone (217) 893-7700

1701 W Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6200

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

2300 N Vermilion St
Danville, IL 61832-1735
Phone (217) 431-7600

516 W Madison St
Danville, IL 61832-5657

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
  • Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316
  • Paris Community Hospital Hospital, Paris, IL, CCN 141320
  • Kirby Medical Center Hospital, Monticello, IL, CCN 141301
  • Gibson Community Hospital Hospital, Gibson City, IL, CCN 141317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
056321GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Richland Memorial Hospital, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Hoopeston Community Memorial Hospital Internal Medicine CurrentSince Mar 24, 2014 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Mar 24, 2014 Accepting new patients
Carle Health Care Incorporated Internal Medicine CurrentSince Apr 1, 2010 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Kirby Medical Center CurrentSince Jan 3, 2026 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

810 W Anthony Dr
Urbana, IL 61802
Phone (217) 326-2911

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1295947083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "CARDIOLOGY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-904-7000",
            "fax_number": "217-904-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGWA",
        "first_name": "MBU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "056321",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225666",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036123786",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036123786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00753211",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036123786",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.