DR. PAULINE MUNGAI M.D.
NPI 1407260953
Internal Medicine in Fort Madison, IA

Q: What is Pauline Mungai's NPI number?

The NPI number for Pauline Mungai is 1407260953. It was assigned to this individual provider in the NPPES registry on June 12, 2014.

Q: What is Pauline Mungai's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Pauline Mungai was last updated on September 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 12, 2014PECOS EnrolledAccepts Medicare Assignment

77.81/100

CMS Quality Rating

5409 AVENUE O, FORT MADISON, IA 52627(319) 376-2134 Get Directions Write a Review

NPPES record last updated: September 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 15, 2020, Sep 28, 2018 (2 updates tracked since 2018).

On this page

About Dr. Pauline Mungai M.d. NPPES

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

DR. PAULINE MUNGAI M.D. (NPI 1407260953) is an individual internal medicine provider in Fort Madison, Iowa, licensed in Iowa (MD44951) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with Southeast Iowa Regional Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1407260953

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. PAULINE MUNGAICredential: M.D.

Location Address5409 AVENUE OFort Madison, IA 52627

Mailing Address5409 Avenue OFort Madison, IA 52627-9601 · (319) 376-2134 · Fax (319) 376-2188

Phone(319) 376-2134

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJune 12, 2014

Last NPPES UpdateSeptember 15, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2020

✔ NPI 1407260953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IA · MD44951

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.

5409 AVENUE O, Fort Madison, IA 52627

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Pauline Mungai M.d. 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 ID6204135817

PECOS Enrollment IDI20181206000453

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.

Areas of Expertise CMS Part B claims 5

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

1,007 services401 patients

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.

140 services117 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

63 services52 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

53 services53 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

40 services32 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southeast Iowa Regional Medical Center

Acute Care Hospitals · West Burlington, IA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160057

Location1221 South Gear AvenueWest Burlington, IA 52655 · Des Moines County

Emergency services Birthing friendly

Henry County Health Center

Critical Access Hospitals · Mount Pleasant, IA

OwnershipGovernment - Local

CMS Certification Number161356

Location407 S White StMount Pleasant, IA 52641 · Henry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52627 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

$122.23 typical visit price

range $52.96 – $161.40

Typical copayment $30.55 (range $13.24 – $40.35)

Most-billed visit code 99204

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $32.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.81/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

67.62

Promoting Interoperability

100

Improvement Activities

Cost

58.43

Referred Medical Equipment & Supplies CMS DME claims 20

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers113 claims248 services$6.05 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers31 claims33 services$1.04 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers16 claims16 services$112.32 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers19 claims40 services$42.39 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers12 claims12 services$68.22 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

4 suppliers17 claims17 services$23.55 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers23 claims23 services$22.58 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers25 claims113 services$3.17 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers21 claims21 services$21.30 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$868.05 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

2 suppliers18 claims18 services$16.15 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier12 claims12 services$7.37 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers24 claims24 services$48.19 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers35 claims35 services$118.00 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

1 supplier11 claims660 services$6.06 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

4 suppliers15 claims3,736 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

5 suppliers17 claims1,950 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

2 suppliers25 claims1,410 services$0.71 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

9 suppliers73 claims74 services$189.17 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

6 suppliers50 claims50 services$23.95 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

WESLEY RIGGS BAGAN M.D.

Surgery

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

GREGORY F GORSKI M.D.

Pediatrics

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

TIMOTHY STAUDTE D.O.

Obstetrics & Gynecology

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

CHASE A. NEWTON D.O.

Family Medicine

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

MRS. MICHELLE LYNN HORNUNG FNP-C

Nurse Practitioner (Family)

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

JAMES G KANNENBERG M.D.

Family Medicine

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

AMY D WALLIS FNP

Nurse Practitioner (Family)

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

KATHY J ANDERSON M.D.

General Practice

5409 AVENUE O
FORT MADISON, IA 52627

Lee County (319) 376-2134

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 Pauline Mungai's NPI number?

The NPI number for Pauline Mungai is 1407260953. It was assigned to this individual provider in the NPPES registry on June 12, 2014.

Where is Pauline Mungai located?

Pauline Mungai practices at 5409 Avenue O, Fort Madison, IA 52627. The listed phone number is (319) 376-2134.

What is Pauline Mungai's specialty?

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

Is Pauline Mungai enrolled in Medicare?

Yes. Pauline Mungai 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.

What insurance does Pauline Mungai accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Pauline Mungai 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.

Is Pauline Mungai affiliated with any hospitals?

According to CMS data, Pauline Mungai is affiliated with Southeast Iowa Regional Medical Center and Henry County Health Center.

When was this NPI record last updated?

The NPPES record for Pauline Mungai was last updated on September 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.