1. Home
  2. Directory
  3. Georgia
  4. Duluth
  5. Internal Medicine
  6. NPI Profile

DR. THEODORA MBANEFO MD
NPI 1376611764
Internal Medicine in Duluth, GA

Active since December 01, 2006PECOS Enrolled
3650 STEVE REYNOLDS BLVD, DEPARTMENT OF INTERNAL MEDICINE, DULUTH, GA 30096(770) 931-6065 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Theodora Mbanefo Md NPPES

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

DR. THEODORA MBANEFO MD (NPI 1376611764) is an individual internal medicine provider in Duluth, Georgia, licensed in Georgia (056596) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376611764
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. THEODORA MBANEFOCredential: MD
Location Address3650 STEVE REYNOLDS BLVD, DEPARTMENT OF INTERNAL MEDICINEDuluth, GA 30096-4506
Mailing Address3495 Piedmont Rd Ne, Nine Piedmont CenterAtlanta, GA 30305-1773 · (404) 364-7000
Phone(770) 931-6065
Sole ProprietorNo
Enumeration DateDecember 1, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376611764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 056596
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3650 STEVE REYNOLDS BLVD, Duluth, GA 30096
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Theodora Mbanefo Md 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.

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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
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.

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.

DR. DANIEL CRAIG GRIZZLE M.D.
Family Medicine
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (770) 931-6220
SHAWNAY NICOLE MAZELL M.D.
Psychiatry & Neurology (Neurology)
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (678) 549-6257
PATRICIA BEATRIZ MASSO MALDONADO AUD
Audiologist
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (404) 365-0966
MS. MICHELLE S BERKOWITZ CNM
Midwife
3650 STEVE REYNOLDS BLVD, DEPARTMENT OF OBSTETRICS & GYNECOLOGY
DULUTH, GA 30096
Gwinnett County (770) 931-6110
LINDA H REMLINGER CNP
Pediatrics
3650 STEVE REYNOLDS BLVD, PEDIATRICS HEALTH CARE TEAM A
DULUTH, GA 30096
Gwinnett County (770) 931-6012
DR. TERI L LAURENTI PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (770) 931-6176
KELLEY WAGES STARNES CNM
Midwife
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (770) 931-6110
LESLIE JEAN QUACKENBUSH LCSW
Social Worker (Clinical)
3650 STEVE REYNOLDS BLVD, GWINNETT COMPREHENSIVE MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (919) 764-2000

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 Theodora Mbanefo's NPI number?

The NPI number for Theodora Mbanefo is 1376611764. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Where is Theodora Mbanefo located?

Theodora Mbanefo practices at 3650 Steve Reynolds Blvd Department Of Internal Medicine, Duluth, GA 30096. The listed phone number is (770) 931-6065.

What is Theodora Mbanefo's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Theodora Mbanefo enrolled in Medicare?

Yes. Theodora Mbanefo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theodora Mbanefo was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.