Individual provider Active NPI

Bibish Mukena

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1619428026
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11034059 Issued in FL
Practice address
102 W Pineloch Ave Ste 23
Orlando, FL 32806-6100
Phone
(407) 852-2760
Fax
(321) 843-6729
NPI assigned
Oct 20, 2016
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11034059 FL Primary
Family Nurse Practitioner 363LF0000X 6731 CT
Family Nurse Practitioner 363LF0000X F339941 NY
Family Nurse Practitioner 363LF0000X AP135197 TX

Addresses

Primary practice location

102 W Pineloch Ave Ste 23
Orlando, FL 32806-6100

Mailing address

102 W Pineloch Ave Ste 23
Orlando, FL 32806-6100
Phone (407) 852-2760

Other practice location 1

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

Other practice location 2

1501 N Amburn Rd Ste 9
Texas City, TX 77591
Phone (281) 218-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170118000491 NY Practitioner - Nurse Practitioner 6800178302 Reassigns benefits to 4 organizations
I20190107002968 TX Practitioner - Nurse Practitioner 6800178302 Reassigns benefits to 1 organization
I20250218003887 FL Practitioner - Nurse Practitioner 6800178302 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

102 W Pineloch Ave
Suite 23
Orlando, FL 32806-6100
Phone (407) 852-2760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6731CTMDFamily Nurse Practitioner
F339941NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Feb 1, 2025 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Mar 19, 2017 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
West Coast Wound and Skin Care Inc CurrentSince Jun 1, 2023 Accepting new patients
Orlando Physicians Network Inc CurrentSince Jul 20, 2025 Accepting new patients
Community Care Health Network LLC CurrentSince Sep 1, 2025 Accepting new patients
Matrix Medical of New York PC CurrentSince Jun 11, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Feb 1, 2025 Accepting new patients
Essen Medical Associates,PC CurrentSince Dec 1, 2016 Accepting new patients
Essen Medical Associates, PC CurrentSince Dec 1, 2016 Accepting new patients
Mobile Advantage Wound Care LLC CurrentSince Jul 17, 2025 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Dec 1, 2016 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

5240 E Knight Dr
Ste 116
Tucson, AZ 85712
Phone (520) 320-5665

2501 W Burbank Blvd
Ste 200
Burbank, CA 91505
Phone (818) 732-8272

102 W Pineloch Ave
Ste 23
Orlando, FL 32806
Phone (407) 481-7139

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

220 N Kirkman Rd
Ste B
Orlando, FL 32811
Phone (407) 408-5910

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

2202 N West Shore Blvd
Tampa, FL 33607
Phone (813) 416-4680

2202 N West Shore Blvd
Ste 200
Tampa, FL 33607
Phone (317) 452-4352

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

101 E Ridge Rd
McAllen, TX 78503
Phone (956) 632-6000

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1619428026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PINELOCH AVE STE 23",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066100",
            "telephone_number": "407-852-2760",
            "fax_number": "321-843-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W PINELOCH AVE STE 23",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066100",
            "telephone_number": "407-852-2760",
            "fax_number": "321-843-6729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104534303",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 N Amburn Rd Ste 9",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "77591",
            "country_code": "US",
            "telephone_number": "281-218-7200",
            "fax_number": "281-218-7203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKENA",
        "first_name": "BIBISH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11034059",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6731",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339941",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.