Individual provider Active NPI

Muzungu Matongo Haamankuli, AGACNP

  • Acute Care Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1942743042
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95005634 Issued in CA
Practice address
300 Pasteur Dr
Palo Alto, CA 94304-2203
Phone
(650) 498-3333
NPI assigned
Nov 22, 2016
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 95005634 CA
Acute Care Nurse Practitioner 363LA2100X 95005634 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Palo Alto, CA 94304-2203

Mailing address

300 Pasteur Dr
Palo Alto, CA 94304-2203
Phone (650) 498-3333

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO, NY, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230906000491 AZ Practitioner - Nurse Practitioner 9133582380 Reassigns benefits to 1 organization
I20230922000334 CO Practitioner - Nurse Practitioner 9133582380 Reassigns benefits to 1 organization
I20240628002703 NY Practitioner - Nurse Practitioner 9133582380 Reassigns benefits to 1 organization
I20241002002639 CA Practitioner - Nurse Practitioner 9133582380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nuvoair Medical PCGroup PAC ID 1557742368, shared by 6 NPIs, 17 clinicians

Practice addresses (Care Compare)

2301 Blake St
Suite 100
Denver, CO 80205-2102
Phone (833) 688-6247

510 Clinton SQ
Rochester, NY 14604-1700
Phone (833) 688-6247

5723 E 5TH St
Tucson, AZ 85711-2401
Phone (833) 688-6247

754 Apple Valley Rd
Lyons, CO 80540-9030
Phone (833) 688-6247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005634CAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Nuvoair Medical PC CurrentSince Apr 13, 2024 Accepting new patients
Nuvoair Medical PC CurrentSince Jul 18, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 26, 2024 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 26, 2024 Accepting new patients
Nuvoair Medical PC CurrentSince Jul 18, 2023 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Stanford Health Care Past Accepting new patients

Locations

1 S Church Ave
Tucson, AZ 85701
Phone (866) 586-4861

1 S Church Ave
Ste 1200
Tucson, AZ 85701
Phone (617) 225-4311

5723 E 5th St
Tucson, AZ 85711
Phone (520) 514-7400

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2425 Geary Blvd
San Francisco, CA 94115
Phone (415) 833-2200

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

50 Milk St
Fl 16
Boston, MA 02109
Phone (617) 213-0335

510 Clinton Sq
Rochester, NY 14604
Phone (561) 208-1970

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27550/brand/1/csg/1/fhir/r4
  • Direct secure messaging: muzungu.haamankuli.1@27550.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1942743042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042203",
            "telephone_number": "650-498-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042203",
            "telephone_number": "650-498-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAMANKULI",
        "first_name": "MUZUNGU",
        "middle_name": "MATONGO",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-22",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "95005634",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95005634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.