Sammy Muthora Mbaya Sr., HCA

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

60992210 Issued in WA

Practice address

2018 156TH Ave NE Ste 2018156
Bellevue, WA 98007-3825

Phone

(425) 440-2727

NPI assigned

May 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mr. Sammy Muthora Mbaya Sr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1467074039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 156TH AVE NE STE 2018156",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073825",
            "telephone_number": "425-440-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 156TH AVE NE STE 2018156",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073825",
            "telephone_number": "425-440-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAYA",
        "first_name": "SAMMY",
        "middle_name": "MUTHORA",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "HCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-17",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WA",
            "license": "60992210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON MEDICAL",
            "identifier": "842212536",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN- HOME CARE AGENCY",
            "identifier": "IFS.FS.60992210",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMMY",
            "last_name": "MBAYA",
            "middle_name": "MUTHORA",
            "prefix": "MR.",
            "suffix": "SR.",
            "credential": "HCA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• In Home Supportive Care Agency in Bellevue, WA
• Providers in Bellevue, WA by specialty
• In Home Supportive Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.