CAROLINE N MBUGUA
NPI 1174398945
Nurse Practitioner - Gerontology in Newark, DE
About Caroline N Mbugua NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CAROLINE N MBUGUA (NPI 1174398945) is an individual gerontology provider in Newark, Delaware, licensed in Delaware (LP-0010658) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Caroline N Mbugua 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.
Medicare Billing Reassignments
5Medicare enrollment records show Caroline Mbugua reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bear, DE 19701
- Reassigned Medicare billing, Delaware enrollment
Wilmington, DE 19808
- Reassigned Medicare billing, Delaware enrollment
- 88 clinicians in this Medicare group
Hockessin, DE 19707
- Reassigned Medicare billing, Delaware enrollment
- 85 clinicians in this Medicare group
Greenville, DE 19807
- Reassigned Medicare billing, Delaware enrollment
- 66 clinicians in this Medicare group
Frederick, MD 21701
- Reassigned Medicare billing, Delaware enrollment
- 80 clinicians in this Medicare group
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 12
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Caroline Mbugua's NPI number?
The NPI number for Caroline Mbugua is 1174398945. It was assigned to this individual provider in the NPPES registry on November 21, 2023.
Where is Caroline Mbugua located?
Caroline Mbugua practices at 4 Peddlers Row Unit 391, Newark, DE 19702. The listed phone number is (617) 365-2164.
What is Caroline Mbugua's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Caroline Mbugua enrolled in Medicare?
Yes. Caroline Mbugua is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Caroline Mbugua's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Caroline Mbugua reassigns Medicare benefits to 5 organizations: Kisima Healthcare LLC (Bear, DE), Delaware Post Acute Medical Services 1 (Wilmington, DE), De Pacs 2 PA (Hockessin, DE), Geriatric Medicine Consultants PA (Greenville, DE) and Cs Pacs 3 Northeast, LLC (Frederick, MD). 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 Caroline Mbugua's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Caroline Mbugua accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Highmark Blue Cross Blue Shield Delaware list Caroline Mbugua 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 Caroline Mbugua was last updated on December 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Caroline N Mbugua · NPI 1174398945
Gerontology physician in Newark, Delaware. Individual provider, active in the CMS NPPES registry since November 21, 2023.
## Identity
- **NPI:** 1174398945 (Entity type: Individual)
- **Enumerated:** November 21, 2023
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** LP-0010658 (Delaware)
- **Sole proprietor:** No
## Practice location
- **Address:** 4 PEDDLERS ROW UNIT 391, Newark, DE 19702-1525
- **Phone:** (617) 365-2164
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Kisima Healthcare LLC (NPI 1801755988, Bear, DE); Delaware Post Acute Medical Services 1 (NPI 1801325717, Wilmington, DE); De Pacs 2 PA (NPI 1457837981, Hockessin, DE); Geriatric Medicine Consultants PA (NPI 1598031643, Greenville, DE); Cs Pacs 3 Northeast, LLC (NPI 1093598898, Frederick, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** December 22, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1174398945) · Data from the CMS NPPES public registry.