Individual provider Active NPI

Martin Ndemelabim Mbuna

  • Community Health Worker
  • Washington, DC
National Provider Identifier
1700140076
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
702 15TH St NE
Washington, DC 20002-4508
Phone
(202) 388-8500
NPI assigned
Jul 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary
Home Health Aide 374U00000X

Addresses

Primary practice location

702 15TH St NE
Washington, DC 20002-4508

Mailing address

702 15TH St NE
Washington, DC 20002-4508
Phone (202) 388-8500

Other practice location 1

7826 Eastern Ave NW
Ll18A
Washington, DC 20012-1324
Phone (202) 722-7776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novacure Inc Current Accepting new patients
JD Nursing & Management Ser Past Accepting new patients
Amazing Love Health Services PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 3

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": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1700140076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 15TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024508",
            "telephone_number": "202-388-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 15TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024508",
            "telephone_number": "202-388-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7826 Eastern Ave NW",
            "address_2": "LL18A",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200121324",
            "country_code": "US",
            "telephone_number": "202-722-7776",
            "fax_number": "202-722-7785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDEMELABIM MBUNA",
        "first_name": "MARTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-01",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.