Sosthene Mballa Ndomo, NP

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0024182625 Issued in VA

Practice address

6463 Rockshire CT
Alexandria, VA 22315-3428

Phone

(571) 208-6962

NPI assigned

Sep 7, 2021

Last updated

Feb 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sosthene Ndomo Mballa Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
• Reston Hospital Center Hospital, Reston, VA, CCN 490107
• Inova Mount Vernon Hospital Hospital, Alexandria, VA, CCN 490122

Merit-based Incentive Payment System (MIPS)

Final score

83.36 of 100Reported as group

Quality

73.03

Promoting interoperability

100

Improvement activities

40

Cost

71.49

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD
• Virginia Critical Care PLLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Lorton, VA
  • NPI 1053067348

  Single Specialty

  Medicare reassignment NPD
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  DC, Single Specialty, VA

  Medicare reassignment NPD
• Inova Health Care Services

  dba Inova Blood Donor Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589

  Single Specialty

  NPD

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

• Inova Health Care Services

  dba Inova Alexandria Hospital

  • General Acute Care Hospital
  • Alexandria, VA
  • NPI 1255684460
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Mount Vernon Hospital

  • General Acute Care Hospital
  • Alexandria, VA
  • NPI 1922139120
  Care Compare affiliation
• Reston Hospital Center LLC

  dba Reston Hospital Center

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1750050522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BLOSSOM LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225544869",
            "telephone_number": "571-208-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6463 ROCKSHIRE CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223153428",
            "telephone_number": "571-208-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDOMO",
        "first_name": "SOSTHENE",
        "middle_name": "MBALLA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024182625",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0024182625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT  OF HEALTH PROFESSIONS",
            "identifier": "0024182625",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOSTHENE",
            "last_name": "NDOMO MBALLA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.