Individual provider Active NPI

Kumba G Komba, FNP-BS

  • Family Nurse Practitioner
  • Bloomsburg, PA
National Provider Identifier
1639738610
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020388 Issued in PA
Practice address
240 Mall Blvd
Bloomsburg, PA 17815-8306
Phone
(570) 784-8303
Fax
(570) 387-5030
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP020388 PA Primary

Addresses

Primary practice location

240 Mall Blvd
Bloomsburg, PA 17815-8306

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 784-8303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200512000149 PA Practitioner - Nurse Practitioner 7214368018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians

Practice addresses (Care Compare)

498 Washington St
Easton, PA 18042-4432
Phone (718) 534-0689

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP020388PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC CurrentSince Aug 1, 2023 Accepting new patients
Wissinoming Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

498 Washington St
Easton, PA 18042
Phone (610) 253-4821

200 Berwick Rd
Orangeville, PA 17859
Phone (570) 683-5036

6122 Torresdale Ave
Philadelphia, PA 19135
Phone (215) 338-6677

5600 Chestnut St
Philadelphia, PA 19139
Phone (215) 836-1508

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1639738610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-784-8303",
            "fax_number": "570-387-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MALL BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158306",
            "telephone_number": "570-784-8303",
            "fax_number": "570-387-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMBA",
        "first_name": "KUMBA",
        "middle_name": "G",
        "credential": "FNP-BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.