Individual provider Active NPI

Laurette Prisca Femnou Mbuntum, M.D.

  • Interventional Cardiology Physician
  • Dallas, TX
National Provider Identifier
1366782856
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
R7050 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone
(214) 590-8000
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X R7050 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7201

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 590-8000

Other names 1

  • Laurette Prisca Kepseu Femnou Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230704000310 TX Practitioner - Cardiovascular Disease (Cardiology) 7214396662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Johns Hopkins University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 831
Dallas, TX 75208-2361
Phone (214) 946-8856

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7050TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Aug 7, 2023 Accepting new patients
Medhealth CurrentSince Aug 7, 2023 Accepting new patients

Locations

221 W Colorado Blvd
Ste 831PAVI
Dallas, TX 75208

4101 Lomo Alto Dr
Dallas, TX 75219
Phone (214) 522-2700

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

221 W Colorado Blvd
Ste 831
Dallas, TX 75208
Phone (214) 942-0091

1441 N Beckley Ave
Ste 438
Dallas, TX 75203

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

Interoperability endpoints

  • Direct secure messaging: lfemnoumbuntum243873@dm.mhd.com
  • Direct secure messaging: lfemnoumbuntum66982@direct.phhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686960000000",
    "number": "1366782856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-590-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-590-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEMNOU MBUNTUM",
        "first_name": "LAURETTE",
        "middle_name": "PRISCA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "R7050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURETTE PRISCA",
            "last_name": "FEMNOU",
            "middle_name": "KEPSEU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.