Active NPI
Sixtus Mbom
- Case Manager/Care Coordinator
- Washington, DC
National Provider Identifier
1902528326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1418 Good Hope Rd SE
Washington, DC 20020-5615 - Phone
- (302) 898-2114
- NPI assigned
- Sep 13, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1418 Good Hope Rd SE
Washington, DC 20020-5615
Mailing address
6933 Lamont Dr
Lanham, MD 20706-4606
Phone (302) 898-2114
Other practice location 1
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Phone (202) 894-6811
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://prestigewecare.com/ | Health Information Exchange (HIE) | |
| Other URL | districthealthcareservices.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1902528326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6933 LAMONT DR",
"city": "LANHAM",
"state": "MD",
"postal_code": "207064606",
"telephone_number": "302-898-2114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 GOOD HOPE RD SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200205615",
"telephone_number": "302-898-2114"
}
],
"practiceLocations": [
{
"address_1": "2811 Pennsylvania Ave SE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200203865",
"country_code": "US",
"telephone_number": "202-894-6811",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MBOM",
"first_name": "SIXTUS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-13",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://prestigewecare.com/",
"affiliation": "N",
"endpointDescription": "official website",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "html",
"address_1": "1418 Good Hope Rd SE",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200205615",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "districthealthcareservices.com",
"affiliation": "N",
"address_1": "2811 Pennsylvania Ave SE",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200203865",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.