Yolande Mfondoum Pengetnze, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

N1059 Issued in TX

Practice address

4200 W University Dr
Prosper, TX 75078-9805

Phone

(945) 204-4100

Fax

(682) 885-1903

NPI assigned

Apr 9, 2008

Sex

Female

Sole proprietor

No

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ypengetnze18394@direct.childrens.com
• Direct secure messaging: ypengetnze216572@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Dallas Physician Medical Services for Children Inc

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1194153650
  Medicare reassignment NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Lubbock, TX
  • NPI 1881399426
  NPD
• Dallas Physician Medical Services for Children Inc

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1558407908
  NPD

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1952574055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789805",
            "telephone_number": "945-204-4100",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENGETNZE",
        "first_name": "YOLANDE",
        "middle_name": "MFONDOUM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "N1059",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N1059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ypengetnze216572@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4200 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750789805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hospitalist Physician in Prosper, TX
• Providers in Prosper, TX by specialty
• Hospitalist Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.