Mamonluk Chua Medical Group, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD037395 Issued in DC

Legal business name

MAMONLUK CHUA MEDICAL GROUP, PC

Practice address

1160 Varnum St NE
Suite # 008
Washington, DC 20017-2110

Phone

(202) 526-3897

Fax

(202) 526-7723

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Ferdinand P Chua, MDNPI 1861474975

Title

President

Phone

(202) 526-3897

Specialties & licenses 2

Addresses

Other names 1

• MCMG Other name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EEJFAA

Practitioners 2

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

• Ferdinand Philip Chua, MD

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1861474975
  Medicare reassignment Care Compare group NPD Authorized official
• Maribel Yap Mamonluk-Chua, MD

  • Allergy & Immunology Physician
  • Washington, DC
  • NPI 1518957307
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1295987436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE # 008",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172110",
            "telephone_number": "202-526-3897",
            "fax_number": "202-526-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "SUITE # 008",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172110",
            "telephone_number": "202-526-3897",
            "fax_number": "202-526-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMONLUK CHUA MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-526-3897",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "DC",
            "license": "MD037327",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD037395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCMG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Senayit Mamo
• Tirunesh G. Mamo
• Tsion Mamo
• Yemeserach W Mamo
• Dora M Mamodesene, MD
• Maribel Yap Mamonluk-Chua, MD
• Diana Mamoud, OD
• Betty Mampuya
• Felicite Che Mamu Epse Nji Fru
• Dong Doe Man

• Internal Medicine Physician in Washington, DC
• Providers in Washington, DC by specialty
• Internal Medicine Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.