Mubangu Mado Mandamuna

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023791 Issued in IL

Practice address

201 N Randolph St
Champaign, IL 61820-3935

Phone

(877) 726-6494

NPI assigned

Sep 8, 2021

Last updated

Jul 24, 2026By 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 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, WA, CA, MS4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmandamuna15648@direct-prd.molinahealthcare.com

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.

• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Molina Healthcare of California

  dba Molina Medical Centers

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  IL, MS

  Medicare reassignment
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1588333033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 SUMMER SAGE CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N RANDOLPH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203935",
            "telephone_number": "877-726-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAMUNA",
        "first_name": "MUBANGU",
        "middle_name": "MADO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907367",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023791",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "209023791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Forcura",
            "affiliation": "N",
            "address_1": "201 N Randolph St",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618203935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Maier
• Joanita A Maison-Bice, APN
• Anastacia Maldonado, MD
• Gabrielle Maloney
• Mark Mammen
• Alyssa Mandell
• Jessica Lynn Mandrell
• Tamara Rochelle Mangal, MD
• Cheryl Mangers
• Sebastiano Rosario Mangiamele, PHARMD

• Family Nurse Practitioner in Champaign, IL
• Providers in Champaign, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.