Debra N/a Mambo, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SPO25773 Issued in PA

Practice address

21 Sand Trap Dr
Royersford, PA 19468-1347

Phone

(267) 975-6514

NPI assigned

Jun 23, 2022

Sex

Female

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 PA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avenues Recovery Medical Center at Valley ForgeGroup PAC ID 3678972130, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Forge Medical Center Hospital, Norristown, PA, CCN 390272

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

76.62

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: debra.mambo@muhammadnadeemshamsipc.chartmakerdirect.com

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.

• Avenues Recovery Medical Center at Valley Forge

  • Addiction Medicine (Family Medicine) Physician
  • Norristown, PA
  • NPI 1326622069

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Muhammad Nadeem Shamsi, PC.

  • Psychiatry Physician
  • Plymouth Meeting, PA
  • NPI 1982824595

  Single Specialty

  Medicare reassignment NPD
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957

  Single Specialty

  Medicare reassignment NPD
• Supportive Care of Pennsylvania LLC

  • Clinical Psychologist
  • Monsey, NY
  • NPI 1174992275

  PA, Single Specialty

  Medicare reassignment NPD
• Avenues Recovery Medical Center at Valley Forge

  • General Acute Care Hospital
  • Norristown, PA
  • NPI 1407430291
  NPD

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

• Avenues Recovery Medical Center at Valley Forge

  • General Acute Care Hospital
  • Norristown, PA
  • NPI 1407430291
  Care Compare affiliation

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1437880937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SAND TRAP DR",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681347",
            "telephone_number": "267-975-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SAND TRAP DR",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681347",
            "telephone_number": "267-975-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMBO",
        "first_name": "DEBRA",
        "middle_name": "N/A",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SPO25773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lumacare Home Health LLC
• Ashley Mace
• Rachel Machen, LPC
• Monica Maddrey, LCSW
• Gary R Major Sr.
• Alaina Kay Markham, D.O.
• Ketty Marquez
• Ellen M Martin, LMT
• Jennifer Mata, LMSW
• Jonathan Mayes

• Psychiatric/Mental Health Nurse Practitioner in Royersford, PA
• Providers in Royersford, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.