Individual provider Active NPI

Odon Makonko Nsungu, MD

  • Internal Medicine Physician
  • Summit, NJ
National Provider Identifier
1891312658
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-48133 Issued in KS
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(908) 522-2000
NPI assigned
Jun 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 04-48133 KS Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230911000848 KS Practitioner - Internal Medicine 0547624587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

14800 W Saint Teresa St
HMP of TX PLLC
Wichita, KS 67235-9602
Phone (316) 268-3976

3600 E Harry St
Via Christi Hosp St Joseph
Wichita, KS 67218-3713
Phone (316) 268-5000

929 N Saint Francis Ave
HMP of TX PLLC
Wichita, KS 67214-3821
Phone (316) 291-4396

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122
  • Via Christi Hospital Wichita St Teresa, Inc Hospital, Wichita, KS, CCN 170200
  • Hutchinson Regional Medical Center Inc Hospital, Hutchinson, KS, CCN 170020
  • Neosho Memorial Regional Medical Center Hospital, Chanute, KS, CCN 171380
  • Susan B Allen Memorial Hospital Hospital, El Dorado, KS, CCN 170017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients

Locations

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

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 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": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1891312658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSUNGU",
        "first_name": "ODON",
        "middle_name": "MAKONKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-28",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "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": "KS",
            "license": "04-48133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.