Mbembo Bongutu, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD062832L Issued in PA

Practice address

201 State St
Erie, PA 16550-0002

Phone

(814) 877-4922

Fax

(814) 877-3622

NPI assigned

Aug 15, 2005

Last updated

Apr 26, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

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

Specialty

Family Practice

Education

George Washington University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Hamot Hospital, Erie, PA, CCN 390063

Merit-based Incentive Payment System (MIPS)

Final score

81.89 of 100Reported as group

Quality

65.8

Promoting interoperability

100

Improvement activities

40

Cost

73.83

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbongutu516676@upmc.direct-ci.com

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.

• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  Medicare reassignment Care Compare group NPD
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1487647590
  NPD (past)
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  NPD (past)

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

• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1487647590
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  Care Compare affiliation

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1851393268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-4922",
            "fax_number": "814-877-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-4922",
            "fax_number": "814-877-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGUTU",
        "first_name": "MBEMBO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD062832L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL ASSISTANCE",
            "identifier": "2228324",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY MEDICAL ASSISTANCE",
            "identifier": "01983279",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080163990",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1645032",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7441061",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "75913",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026887601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "P001411",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016842690006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "323780",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenn Alden Bollard, MD
• Michelle Bollom, OTD, OTR/L, CTRS-C
• Christopher Michael Bolton
• Vanessa Bonatto, LCSW
• Erica Lyn Boncella, LPC
• Megan Gwendolyn Bonk
• Tara Lynn Bonovitch, LPN
• Rosalie Anne Bonus, PA
• Rachel Bonyai, MSW
• Angela M Bootes, CRNP

• Family Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.