Khotwanaeya A Mwamba, MD - Medicare Pediatrics in Tyler, TX

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Khotwanaeya A Mwamba, MD is a medicare enrolled "Pediatrics" physician in Tyler, Texas. Her current practice location is 2231 W Gentry Pkwy, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 535-9041.

Khotwanaeya A Mwamba is licensed to practice in Texas (license number R6634) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205198421.

Contact Information

Khotwanaeya A Mwamba, MD
2231 W Gentry Pkwy,
Tyler, TX 75702-2809
(903) 535-9041
(903) 787-5098

Map and Direction




Physician's Profile

Full NameKhotwanaeya A Mwamba
GenderFemale
SpecialityPediatrics
Location2231 W Gentry Pkwy, Tyler, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1205198421
  • Provider Enumeration Date: 06/13/2012
  • Last Update Date: 05/13/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0749593820
  • Enrollment ID: I20171017003312

Medical Identifiers

Medical identifiers for Khotwanaeya A Mwamba such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205198421NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics R6634 (Texas)Primary
208000000XPediatrics 49873 (Arizona)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Khotwanaeya A Mwamba allows following entities to bill medicare on her behalf.
Entity NameSan Carlos Apache Healthcare Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265813075
PECOS PAC ID: 0648580597
Enrollment ID: O20151105002091

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Khotwanaeya A Mwamba is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Khotwanaeya A Mwamba, MD
523 S Fannin Ave,
Tyler, TX 75702-8204

Ph: (903) 535-9041		Khotwanaeya A Mwamba, MD
2231 W Gentry Pkwy,
Tyler, TX 75702-2809

Ph: (903) 535-9041

Reviews and Comments


Pediatrics Doctors in Tyler, TX

Krystal Castle, DO
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Practice Location: 305 W Rusk St, Tyler, TX 75701
Phone: 903-592-7304    
Daniel Jun Park, M.D.
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Practice Location: 8288 S Broadway Ave, Tyler, TX 75703
Phone: 903-606-7060    Fax: 903-606-7129
Mrs. Valerie B Smith, MD
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Medicare: May Accept Medicare Assignments
Practice Location: 1350 E Richards St, Tyler, TX 75702
Phone: 903-531-9455    Fax: 903-526-3118
Dr. Juwairriyyah Abdul Wahid Siddiqui, MD
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Medicare: May Accept Medicare Assignments
Practice Location: 8934 S Broadway Ave Ste 448, Tyler, TX 75703
Phone: 903-606-5100    Fax: 903-606-5105
Ms. Yanique Tavia Ellis, MD
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Medicare: Not Enrolled in Medicare
Practice Location: 2900 North Broadway Ave, Tyler, TX 75702
Phone: 903-593-1892    
Kristina Orey Mitchell, M.D.
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Medicare: Medicare Enrolled
Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701
Phone: 903-596-3862    Fax: 903-590-5005
Adelina G. Meadows, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 8934 S Broadway Ave Ste 448, Tyler, TX 75703
Phone: 903-606-5100    Fax: 903-606-5105

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.