STANISLAUS MBONG EBAKO RN
NPI 1063715787
Registered Nurse in Alexandria, VA

Q: What is Stanislaus Ebako's NPI number?

The NPI number for Stanislaus Ebako is 1063715787. It was assigned to this individual provider in the NPPES registry on December 20, 2010.

Q: What is Stanislaus Ebako's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Stanislaus Ebako was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 20, 2010PECOS Enrolled

4850 MARK CENTER DR, ALEXANDRIA, VA 22311(703) 746-3400 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Stanislaus Mbong Ebako Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STANISLAUS MBONG EBAKO RN (NPI 1063715787) is an individual registered nurse in Alexandria, Virginia, licensed in Virginia (0001214658) and active in the NPI registry since December 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1063715787

Entity TypeIndividualMale

Primary Taxonomy163W00000X

Provider Legal NameSTANISLAUS MBONG EBAKOCredential: RN

Location Address4850 MARK CENTER DRAlexandria, VA 22311-1882

Mailing Address4850 Mark Center DrAlexandria, VA 22311-1882 · (703) 746-3400

Phone(703) 746-3400

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateDecember 20, 2010

Last NPPES UpdateJune 13, 2024

NPPES CertifiedJune 13, 2024

✔ NPI 1063715787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

License✔ Licensed in VA · 0001214658

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

4850 MARK CENTER DR, Alexandria, VA 22311

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stanislaus Mbong Ebako Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729583984

PECOS Enrollment IDI20250926002832

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN E FRUTOS LCSW

Social Worker (Clinical)