Susan Mbugua, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201508014NPPP Issued in OR

Practice address

3939 NE Hancock St Ste 202
Portland, OR 97212-5321

Phone

(971) 357-1234

NPI assigned

Oct 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Imani Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1104415405
  Medicare reassignment NPD Authorized official
• Imani Residential Treatment Home

  • Mental Illness Community Based Residential Treatment Facility
  • Beaverton, OR
  • NPI 1417898941
  NPD Authorized official
• Optimal Home Care Agency Company

  • In Home Supportive Care Agency
  • Beaverton, OR
  • NPI 1891418083
  NPD Authorized official
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1932503539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SW CEDAR HILLS BLVD # 142",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051354",
            "telephone_number": "214-743-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK ST STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125321",
            "telephone_number": "971-357-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBUGUA",
        "first_name": "SUSAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP126656",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201508014NPPP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smbugua798629@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10202 SE 32nd Ave Ste 701",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972223625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Arielle Mazzuca
• Scott Joseph Mazzulo
• Osinakachukwu Mbata, MD
• Ruth Nyambura Mbatia
• Mbody Health, LLC
• Deborah Ann MC Bride, O.D.
• Keira Marie MC Menamin, MS, OTR/L
• Rebekah MC Quade, RN
• Brittany McAdams
• Erin Anne McAdams, MSW

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.