NPIMap

Individual provider Active NPI

Collins Mbugua Mbaria, M.D

  • Internal Medicine Physician
  • Washington, NC
National Provider Identifier
1750732962
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2019-01889 Issued in NC
Practice address
628 E 12TH St
Washington, NC 27889-3409
Phone
(252) 975-4100
NPI assigned
Jun 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2019-01889 NC Primary

Addresses

Primary practice location

628 E 12TH St
Washington, NC 27889-3409

Mailing address

628 E 12TH St
Washington, NC 27889-3409
Phone (252) 975-4100

Other identifiers 1

IdentifierTypeStateIssuer
1750732962MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmbaria291952@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003002451 NC Practitioner - Internal Medicine 6204175888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

628 E 12TH St
Vidant Beaufort Hospitalists
Washington, NC 27889-3409
Phone (252) 975-4178

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC Internal Medicine CurrentSince Apr 25, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 23, 2019 Accepting new patients
Pitt County Memorial Hospital Inc Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

Interoperability endpoints

  • Direct secure messaging: cmbaria291952@direct.vidanthealth.com

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.

Hospital & facility affiliations 2

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1750732962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "252-975-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "252-975-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBARIA",
        "first_name": "COLLINS",
        "middle_name": "MBUGUA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-01889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750732962",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmbaria291952@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.