Nkangu Kenneth Fomengia, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C0006385 Issued in MD

Practice address

9000 Woodyard Rd
Clinton, MD 20735-4206

Phone

(240) 546-3428

Fax

(240) 546-3429

NPI assigned

Oct 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, shared by 26 NPIs, 258 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdexchange@patientfirstclinics.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.

• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Silver Spring, MD
  • NPI 1265866503

  DC

  Medicare reassignment NPD
• Patient First Maryland Medical Group, PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1962423632

  MD

  Medicare reassignment NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Waldorf, MD
  • NPI 1205087517
  NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Capitol Heights, MD
  • NPI 1427807999
  NPD

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1588069694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WOODYARD RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354206",
            "telephone_number": "240-546-3428",
            "fax_number": "240-546-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMENGIA",
        "first_name": "NKANGU",
        "middle_name": "KENNETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "C0006385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9000 Woodyard Rd",
            "city": "Clinton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207354206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Floss Family Dentistry, LLCS
• Tanya Joy Flowers
• Kevin M Ford, MD
• Marlena Foreman
• Dorothy Nyenju Fowanko
• Rhonda B Fowler, DPT
• Francis D Dickson MD, PC

• Family Medicine Physician in Clinton, MD
• Providers in Clinton, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.