Eucharia Mambo Kenta-Bibi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

051460 Issued in CT

Practice address

1000 Silver Street
Connecticut Valley Hospital
Middletown, CT 06457-7023

Phone

(860) 262-5154

Fax

(860) 262-5122

NPI assigned

Nov 13, 2008

Last updated

Nov 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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 CT

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

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Connecticut

  dba Connecticut Valley Hospital

  • Psychiatric Hospital
  • Middletown, CT
  • NPI 1245256247
  Medicare reassignment Care Compare group NPD
• State of Connecticut

  dba Department of Veterans' Affairs, Veterans Home

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1578717815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SILVER STREET",
            "address_2": "CONNECTICUT VALLEY HOSPITAL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577023",
            "telephone_number": "860-262-5154",
            "fax_number": "860-262-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SILVER STREET",
            "address_2": "CONNECTICUT VALLEY HOSPITAL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577023",
            "telephone_number": "860-262-5154",
            "fax_number": "860-262-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENTA-BIBI",
        "first_name": "EUCHARIA",
        "middle_name": "MAMBO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "051460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gillian R. Kelly, D.M.D.,M.S.D.
• Mary Ann Kelly, APRN
• Michael Kelly, DMD
• Kate Kennedy, LCSW
• Emmanuel Kenta-Bibi, MD
• Karen Keramidas, RN
• Richard M. Ketai, M.D.
• Kevin O'Shea, PSYD LLC
• Hilary Osga Khacherian, OTRL
• Anwar M Khan, MD

• Family Medicine Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.