BUPE C MUSHILI NP
NPI 1124711965
Nurse Practitioner - Psychiatric/Mental Health in Glendora, CA

Q: What is Bupe Mushili's NPI number?

The NPI number for Bupe Mushili is 1124711965. It was assigned to this individual provider in the NPPES registry on May 29, 2023.

Q: What is Bupe Mushili's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Bupe Mushili was last updated on April 4, 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 May 29, 2023PECOS Enrolled

415 W ROUTE 66 STE 202, GLENDORA, CA 91740(626) 963-4467(626) 963-9543 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 4, 2024, Nov 1, 2023, Aug 30, 2023 and 1 more (4 updates tracked since 2023).

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About Bupe C Mushili Np NPPES

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

BUPE C MUSHILI NP (NPI 1124711965) is an individual psychiatric/mental health provider in Glendora, California, licensed in California (95025342) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Diamond Bar.

NPPES Registry Identity

NPI1124711965

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameBUPE C MUSHILICredential: NP

Location Address415 W ROUTE 66 STE 202Glendora, CA 91740-4335

Mailing Address3400 Inland Empire Blvd Ste 101Ontario, CA 91764-5577 · (909) 870-0160 · Fax (909) 870-0161

Phone(626) 963-4467

Fax(626) 963-9543

Sole ProprietorYes

Enumeration DateMay 29, 2023

Last NPPES UpdateApril 4, 20244 updates tracked since enumeration

NPPES CertifiedApril 4, 2024

✔ NPI 1124711965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95025342

415 W ROUTE 66 STE 202, Glendora, CA 91740

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Secondary Practice Location 1

Location 12705 S Diamond Bar Blvd Ste 238Diamond Bar, CA 91765-3554 · Phone (909) 860-2166 · Fax (626) 963-9543

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bupe C Mushili 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 Reassignment

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

Dr Jacob & Associates Inc

0.6 mi

Psychiatry

415 W ROUTE 66, STE 202
Glendora, CA 91740

Reassigned Medicare billing, California enrollment
19 clinicians in this Medicare group

NPI 1932997467 (626) 963-4467

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 91740 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 20

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

LORENA LLANET FUENTES PMHNP

Nurse Practitioner (Psychiatric/Mental Health)