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MRS. EDELINE MUTANGA N.P
NPI 1083032981
Nurse Practitioner - Family in Shenandoah, TX

Active since March 29, 2014PECOS Enrolled
111 VISION PARK BLVD STE 100, SHENANDOAH, TX 77384(713) 714-1399(713) 389-5798 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Edeline Mutanga N.p NPPES

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

MRS. EDELINE MUTANGA N.P (NPI 1083032981) is an individual family provider in Shenandoah, Texas, licensed in Texas (841378) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083032981
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. EDELINE MUTANGACredential: N.P
Location Address111 VISION PARK BLVD STE 100Shenandoah, TX 77384-3003
Mailing Address28326 Jonsport LnSpring, TX 77386-1845 · (315) 534-9441
Phone(713) 714-1399
Fax(713) 389-5798
Sole ProprietorNo
Enumeration DateMarch 29, 2014
Last NPPES UpdateFebruary 8, 2024
NPPES CertifiedFebruary 8, 2024
✔ NPI 1083032981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 841378
111 VISION PARK BLVD STE 100, Shenandoah, TX 77384
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Edeline Mutanga N.p is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Edeline Mutanga reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Procura Pain And Spine, PLLC
Same address
Pain Medicine
111 VISION PARK BLVD STE 100
Shenandoah, TX 77384
  • Reassigned Medicare billing, Texas enrollment
  • 9 clinicians in this Medicare group
NPI 1245663848 (713) 714-1399

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77384 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

PROCURA PAIN AND SPINE, PLLC
Anesthesiology (Pain Medicine)
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
SPRINTZ CENTER FOR RECOVERY, PLLC
Preventive Medicine (Addiction Medicine)
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
MR. SCOTT EDWARD ANDERSON PA-C
Physician Assistant
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
ELLA DICKENS MS, LPC, LCDC
Counselor (Professional)
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
DR. YOANN HENRY MILLET M.D.
Pain Medicine (Interventional Pain Medicine)
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
CASSANDRA SMITH PAC
Physician Assistant
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399
DR. KENNETH QIAN WU M.D.
Pain Medicine (Interventional Pain Medicine)
111 VISION PARK BLVD STE 100
SHENANDOAH, TX 77384
Montgomery County (713) 714-1399

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edeline Mutanga's NPI number?

The NPI number for Edeline Mutanga is 1083032981. It was assigned to this individual provider in the NPPES registry on March 29, 2014.

Where is Edeline Mutanga located?

Edeline Mutanga practices at 111 Vision Park Blvd Ste 100, Shenandoah, TX 77384. The listed phone number is (713) 714-1399.

What is Edeline Mutanga's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Edeline Mutanga enrolled in Medicare?

Yes. Edeline Mutanga is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Edeline Mutanga's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edeline Mutanga reassigns Medicare benefits to Procura Pain And Spine, PLLC (Shenandoah, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edeline Mutanga's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Edeline Mutanga was last updated on February 8, 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.