Individual provider Active NPI

Magdalyne Nyambura Berengu

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1720768823
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2345510 Issued in MA
Practice address
9201 E Mountain View Rd
Scottsdale, AZ 85258-5199
Phone
(877) 564-3627
NPI assigned
Jul 24, 2023
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2345510 MA Primary
Family Nurse Practitioner 363LF0000X 15368 CT

Addresses

Primary practice location

9201 E Mountain View Rd
Scottsdale, AZ 85258-5199

Mailing address

480 Locust St
Raynham, MA 02767-1177
Phone (774) 223-8455

Other practice location 1

418 Belmont St
Brockton, MA 02301-4955
Phone (774) 203-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, KY, CT3 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
I20230816002560 MA Practitioner - Nurse Practitioner 1658733092 Reassigns benefits to 1 organization
I20250128001220 KY Practitioner - Nurse Practitioner 1658733092 Reassigns benefits to 1 organization
I20251013000480 CT Practitioner - Nurse Practitioner 1658733092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

480 Locust St
Raynham, MA 02767-1177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. Single Specialty CurrentSince Sep 11, 2023 Accepting new patients
Imedical365 Inc Single Specialty Past Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752

5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267

1075 Main St
Fl 4
Waltham, MA 02451

Interoperability endpoints

  • Direct secure messaging: mberengu15009@direct-prd.molinahealthcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1720768823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 LOCUST ST",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671177",
            "telephone_number": "774-223-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585199",
            "telephone_number": "877-564-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023014955",
            "country_code": "US",
            "telephone_number": "774-203-4777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERENGU",
        "first_name": "MAGDALYNE",
        "middle_name": "NYAMBURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2345510",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "15368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.