Individual provider Active NPI

Wongani Munthali

  • Family Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1467030833
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0996428 Issued in CO
Practice address
5376 S Haleyville Way
Aurora, CO 80016-5874
Phone
(410) 979-4856
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03211191 CO
Family Nurse Practitioner 363LF0000X 0996428 CO Primary

Addresses

Primary practice location

5376 S Haleyville Way
Aurora, CO 80016-5874

Mailing address

5376 S Haleyville Way
Aurora, CO 80016-5874

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210430000191 CO Practitioner - Nurse Practitioner 0749699924 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0996428COMDFamily Nurse Practitioner
F03211191COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Hearts Internal Medicine & Geriatric Care PC CurrentSince May 1, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jun 15, 2024 Accepting new patients

Locations

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (303) 285-1148

7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420

7950 W Mississippi Ave
Lakewood, CO 80226
Phone (303) 422-1533

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1467030833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5376 S HALEYVILLE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5376 S HALEYVILLE WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165874",
            "telephone_number": "410-979-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTHALI",
        "first_name": "WONGANI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "F03211191",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0996428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.