Individual provider Active NPI

Tinotenda Chiedza Mupambo

  • Speech-Language Pathologist
  • Mankato, MN
National Provider Identifier
1851085658
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528570 Issued in MN
Practice address
150 South Rd
Mankato, MN 56001-7046
Phone
(507) 389-6298
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528570 MN Primary

Addresses

Primary practice location

150 South Rd
Mankato, MN 56001-7046

Mailing address

150 South Rd
Mankato, MN 56001-7046
Phone (507) 389-6298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000670 MN Practitioner - Qualified Speech Language Pathologist 4082069703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota State Colleges and UniversitiesGroup PAC ID 2264334663, 12 clinicians

Practice addresses (Care Compare)

150 S Rd
Mankato, MN 56001-7046
Phone (507) 389-6298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
528570MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota State Colleges and Universities CurrentSince Sep 2, 2023 Accepting new patients
Minnesota State Colleges and Universities CurrentSince Sep 2, 2023 Accepting new patients
Minnesota State Colleges & Universities Speech-Language Pathologist Current Accepting new patients

Locations

150 South Rd
Mankato, MN 56001
Phone (507) 389-2147

1104 7th Ave S
Moorhead, MN 56563
Phone (218) 477-2330

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1851085658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SOUTH RD",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017046",
            "telephone_number": "507-389-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SOUTH RD",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017046",
            "telephone_number": "507-389-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUPAMBO",
        "first_name": "TINOTENDA",
        "middle_name": "CHIEDZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.