Individual provider Active NPI

Maliseni Mpundu Mulenga, CRNP

  • Nurse Practitioner
  • Hershey, PA
National Provider Identifier
1982462909
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP029209 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(800) 243-1455
NPI assigned
Mar 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP029209 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr
MC Ca410
Hershey, PA 17033-2360
Phone (717) 531-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240617002331 PA Practitioner - Nurse Practitioner 4880137025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Medical GroupGroup PAC ID 3779688650, 190 clinicians
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

3970 Perkiomen Ave
Suite 102
Reading, PA 19606-2757
Phone (610) 779-1330

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8815

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Medical Group CurrentSince Sep 1, 2025 Accepting new patients
St. Joseph Medical Group CurrentSince Sep 1, 2025 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Apr 22, 2024 Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Apr 22, 2024 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

3025 Market St
Ste A
Camp Hill, PA 17011
Phone (717) 761-8900

121 N Nyes Rd
Ste C
Harrisburg, PA 17112
Phone (717) 657-4045

1150 Cocoa Ave
Hershey, PA 17033
Phone (717) 531-6015

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A4
Hershey, PA 17033
Phone (717) 531-6261

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

3970 Perkiomen Ave
Ste 102
Reading, PA 19606
Phone (610) 779-1330

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

Organizations & group practices 6

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 3

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": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1982462909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8885",
            "fax_number": "717-531-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-243-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULENGA",
        "first_name": "MALISENI",
        "middle_name": "MPUNDU",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP029209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.