Mubangu Mado Mandamuna, is a medicare enrolled "Nurse Practitioner - Family" physician in Champaign, Illinois. She graduated from medical school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is
201 N Randolph St, Champaign, Illinois. You can reach out to her office (for appointments etc.) via phone at
(877) 726-6494.
Mubangu Mado Mandamuna is licensed to practice in Illinois (license number 209023791) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1588333033.
Physician's Profile
| Full Name | Mubangu Mado Mandamuna |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 201 N Randolph St, Champaign, Illinois |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mubangu Mado Mandamuna graduated from medical school in 2020
NPI Data:
- NPI Number: 1588333033
- Provider Enumeration Date: 09/08/2021
- Last Update Date: 12/29/2022
Medicare PECOS Information:
- PECOS PAC ID: 4183095144
- Enrollment ID: I20250425000084
Medical Identifiers
Medical identifiers for Mubangu Mado Mandamuna such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1588333033 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QH0002X | Family Medicine - Hospice And Palliative Medicine | 209023791 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209023791 (Illinois) | Primary |
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. Mubangu Mado Mandamuna allows following entities to bill medicare on her behalf.
| Entity Name | Molina Care Connections, Llc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407243223
PECOS PAC ID: 5799062881
Enrollment ID: O20250120000531 |
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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. Mubangu Mado Mandamuna 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 Address | Practice Location Address |
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Mubangu Mado Mandamuna,
3723 Summer Sage Ct,
Champaign, IL 61822-1907
Ph: () - | Mubangu Mado Mandamuna,
201 N Randolph St,
Champaign, IL 61820-3935
Ph: (877) 726-6494 |
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