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MRS. MAMBOH NGUM YUFENYUY NP
NPI 1104174531
Nurse Practitioner - Adult Health in Duluth, GA

Active since August 15, 2012PECOS Enrolled
1657 SOUTHGATE MILL DR NW, DULUTH, GA 30096(678) 977-5976 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mrs. Mamboh Ngum Yufenyuy Np NPPES

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

MRS. MAMBOH NGUM YUFENYUY NP (NPI 1104174531) is an individual adult health provider in Duluth, Georgia, licensed in Georgia (RN188604) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104174531
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. MAMBOH NGUM YUFENYUYCredential: NP
Location Address1657 SOUTHGATE MILL DR NWDuluth, GA 30096
Mailing Address1657 Southgate Mill Dr NwDuluth, GA 30096-8837 · (678) 977-5976
Phone(678) 977-5976
Sole ProprietorYes
Enumeration DateAugust 15, 2012
Last NPPES UpdateApril 12, 2022
NPPES CertifiedApril 12, 2022
✔ NPI 1104174531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in GA · RN188604
Also ListedRegistered Nurse · Ambulatory CareTaxonomy 163WP2201X · License 17691 (TN)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN188604 (GA)
1657 SOUTHGATE MILL DR NW, Duluth, GA 30096
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mamboh Ngum Yufenyuy Np 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 Reassignments

3

Medicare enrollment records show Mamboh Yufenyuy reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Southeast Permanente Medical Group
15 mi
Internal Medicine
3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305
  • Reassigned Medicare billing, Georgia enrollment
  • 1,389 clinicians in this Medicare group
NPI 1245266956 (404) 364-3821
Community Care Health Network LLC
214 mi
Nurse Practitioner
424 CHURCH ST STE 220
Nashville, TN 37219
  • Reassigned Medicare billing, Georgia enrollment
  • 274 clinicians in this Medicare group
NPI 1619368842 (877) 564-3627
Signify Health Medical Associates, PLLC
737 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Georgia enrollment
  • 488 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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 30096 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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 Mamboh Yufenyuy's NPI number?

The NPI number for Mamboh Yufenyuy is 1104174531. It was assigned to this individual provider in the NPPES registry on August 15, 2012.

Where is Mamboh Yufenyuy located?

Mamboh Yufenyuy practices at 1657 Southgate Mill Dr NW, Duluth, GA 30096. The listed phone number is (678) 977-5976.

What is Mamboh Yufenyuy's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Mamboh Yufenyuy enrolled in Medicare?

Yes. Mamboh Yufenyuy is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mamboh Yufenyuy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mamboh Yufenyuy reassigns Medicare benefits to 3 organizations: The Southeast Permanente Medical Group (Atlanta, GA), Community Care Health Network LLC (Nashville, TN) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Mamboh Yufenyuy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mamboh Yufenyuy accept?

Health plans from CareSource (Common Ground Healthcare) list Mamboh Yufenyuy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mamboh Yufenyuy was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.