NPIMap

Individual provider Active NPI

Emmanuel Ted Mbualungu, MD

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1881749166
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21791 Issued in DC
Practice address
106 Irving St NW
Suite 403
Washington, DC 20010-2989
Phone
(202) 291-1645
Fax
(202) 291-1062
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21791 DC Primary

Addresses

Primary practice location

106 Irving St NW
Suite 403
Washington, DC 20010-2989

Mailing address

14600 Cedar Knoll Dr
Centreville, VA 20120-2895
Phone (703) 968-2855

Other identifiers 1

IdentifierTypeStateIssuer
22932100MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040524000213 DC Practitioner - Internal Medicine 1052302999 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

106 Irving St NW
Washington, DC 20010-2989

106 Irving St NW 4200
MMG at WHC
Washington, DC 20010-2979
Phone (202) 877-2200

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

Merit-based Incentive Payment System (MIPS)

Final score
70.51 of 100Reported as individual
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
85.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21791DCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WHC Physician Group LLC Current Accepting new patients
Medstar Total Elder Care LLC CurrentSince Jul 22, 2017 Accepting new patients
Unity Health Care Inc. CurrentSince Jul 24, 2015 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2021 Accepting new patients
Medstar Heart Institute LLC CurrentSince Apr 1, 2016 Accepting new patients
WHC Emerg Phys CurrentSince Apr 1, 2016 Accepting new patients
Etm,Inc Internal Medicine CurrentSince Jun 1, 2004 Accepting new patients
Unity Health Care, Inc. CurrentSince Jul 24, 2015 Accepting new patients
WHC Physician Group LLC CurrentSince Apr 1, 2016 Accepting new patients
Medstar Washington Hospital Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

106 Irving St NW
Ste 403
Washington, DC 20010
Phone (202) 291-1645

106 Irving St NW
Ste 4200
Washington, DC 20010
Phone (202) 877-2200

110 Irving St NW
Rm 3114
Washington, DC 20010
Phone (202) 877-0570

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

106 Irving St NW
Washington, DC 20010
Phone (202) 877-0275

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

Organizations & group practices 12

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 7

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1881749166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 CEDAR KNOLL DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201202895",
            "telephone_number": "703-968-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW",
            "address_2": "SUITE 403",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102989",
            "telephone_number": "202-291-1645",
            "fax_number": "202-291-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBUALUNGU",
        "first_name": "EMMANUEL",
        "middle_name": "TED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "21791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22932100",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.