JUDITH MONGOUM PENE FNP
NPI 1134767759
Nurse Practitioner - Family in Crystal Lake, IL

Q: What is Judith Mongoum Pene's NPI number?

The NPI number for Judith Mongoum Pene is 1134767759. It was assigned to this individual provider in the NPPES registry on December 13, 2019.

Q: What is Judith Mongoum Pene's specialty?

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

Active since December 13, 2019PECOS EnrolledAccepts Medicare Assignment

1305 RANDALL RD, CRYSTAL LAKE, IL 60014(815) 386-0386 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 31, 2023, May 13, 2021, May 4, 2021 and 2 more (5 updates tracked since 2019).

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About Judith Mongoum Pene Fnp NPPES

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

JUDITH MONGOUM PENE FNP (NPI 1134767759) is an individual family provider in Crystal Lake, Illinois, licensed in Illinois (209.020328) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1134767759

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJUDITH MONGOUM PENECredential: FNP

Location Address1305 RANDALL RDCrystal Lake, IL 60014-8601

Mailing Address1305 Randall RdCrystal Lake, IL 60014-8601 · (815) 356-0386

Phone(815) 386-0386

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateDecember 13, 2019

Last NPPES UpdateMay 31, 20235 updates tracked since enumeration

NPPES CertifiedMay 31, 2023

✔ NPI 1134767759 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 IL · 209.020328

1305 RANDALL RD, Crystal Lake, IL 60014

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Judith Mongoum Pene Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547695736

PECOS Enrollment IDI20200116000626

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

Medicare enrollment records show Judith Mongoum Pene reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Chicago Medical Group, Inc.

45 mi

Multi-Specialty

15255 S 94TH AVE STE 500
Orland Park, IL 60462

Reassigned Medicare billing, Illinois enrollment
23 clinicians in this Medicare group

NPI 1285972505 (708) 800-2231

Minuteclinic Diagnostic Of Illinois PLLC

50 mi

Family

11200 W LINCOLN HWY
Mokena, IL 60448

Reassigned Medicare billing, Illinois enrollment
223 clinicians in this Medicare group

NPI 1356485809 (866) 389-2727

Minuteclinic Primary Care Illinois PLLC

50 mi

Family

11200 LINCOLN HWY
Mokena, IL 60448

Reassigned Medicare billing, Illinois enrollment
115 clinicians in this Medicare group

NPI 1528875564 (866) 389-2727

Minuteclinic Video Virtual Care North, LLC

50 mi

Family

11200 LINCOLN HWY
Mokena, IL 60448

Reassigned Medicare billing, Illinois enrollment
99 clinicians in this Medicare group

NPI 1518512227 (866) 389-2727

Signify Health Medical Associates, PLLC

788 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, Illinois enrollment
712 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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

36 services36 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

26 services26 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60014 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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 15

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

ERIN WILLIAMS

Nurse Practitioner (Psychiatric/Mental Health)