Individual provider Active NPI

Austine Y. Mengnjo, M.D.

  • Nephrology Physician
  • Wyomissing, PA
National Provider Identifier
1770712945
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD443487 Issued in PA
Practice address
1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029
Phone
(610) 376-7365
Fax
(610) 376-1320
NPI assigned
Jul 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD443487 PA Primary

Addresses

Primary practice location

1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029

Mailing address

1030 Reed Avenue
Suite 114
Wyomissing, PA 19610-2029
Phone (610) 376-7365

Other identifiers 1

IdentifierTypeStateIssuer
1026546140002MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000610 PA Practitioner - NephrologyPractitioner - Internal Medicine 5991839250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reading Nephrology, LTDGroup PAC ID 2062451578, 13 clinicians

Practice addresses (Care Compare)

1030 Reed Ave
Suite 114
Wyomissing, PA 19610-2039
Phone (610) 376-7365

Hospital & facility affiliations

  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD443487PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Nephrology, LTD Nephrology CurrentSince Jul 2, 2012 Accepting new patients

Locations

220 N Park Rd
Wyomissing, PA 19610

1030 Reed Ave
Ste 114
Wyomissing, PA 19610
Phone (610) 376-7365

Interoperability endpoints

  • Direct secure messaging: drmengnjo@readingnephrology.medentdirect.com

Organizations & group practices 1

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 8

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1770712945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 REED AVENUE",
            "address_2": "SUITE 114",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102029",
            "telephone_number": "610-376-7365",
            "fax_number": "610-376-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 REED AVENUE",
            "address_2": "SUITE 114",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102029",
            "telephone_number": "610-376-7365",
            "fax_number": "610-376-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGNJO",
        "first_name": "AUSTINE",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD443487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026546140002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.