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MRS. GWENDOLINE MBAKU FNP
NPI 1447624853
Nurse Practitioner - Family in Dallas, TX

Active since November 23, 2015PECOS Enrolled
3133 E LEMMON AVE, DALLAS, TX 75204(866) 389-2727(401) 216-3854 Get Directions Write a Review

NPPES record last updated: October 7, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2016, Nov 23, 2015 (2 updates tracked since 2015).

About Mrs. Gwendoline Mbaku Fnp NPPES

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

MRS. GWENDOLINE MBAKU FNP (NPI 1447624853) is an individual family provider in Dallas, Texas, licensed in Texas (AP129670) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447624853
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. GWENDOLINE MBAKUCredential: FNP
Location Address3133 E LEMMON AVEDallas, TX 75204-1411
Mailing Address15175 Palo Pinto DrFrisco, TX 75035-5556 · (214) 682-5236
Phone(866) 389-2727
Fax(401) 216-3854
Sole ProprietorNo
Enumeration DateNovember 23, 2015
Last NPPES UpdateOctober 7, 20162 updates tracked since enumeration
✔ NPI 1447624853 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 TX · AP129670
3133 E LEMMON AVE, Dallas, TX 75204
Open in Google Maps ↗

Other Identifiers 2

Medicaid3567679TX
Medicare PIN470263ZHSB

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Gwendoline Mbaku Fnp 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 Gwendoline Mbaku reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Legacy Physiatry Group LLC
15 mi
Physical Medicine & Rehabilitation
850 CENTRAL PKWY E STE 275
Plano, TX 75074
  • Reassigned Medicare billing, Texas enrollment
  • 96 clinicians in this Medicare group
NPI 1316078769 (972) 881-4688

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 75204 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

ROSHNI A MAPARA
Pharmacist
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2018
JARED HULLABY
Pharmacist
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
MACKENZIE RANDOLPH
Nurse Practitioner (Family)
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
ESSENCE HALL PHARMD
Pharmacist
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
CEMILE LITTLEPAGE FNP-C
Nurse Practitioner (Family)
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
MICHELLE KONG
Nurse Practitioner (Family)
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
DR. CATVU LUONG PHARMD
Pharmacist
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108
KELLY KWAK
Pharmacist
3133 E LEMMON AVE
DALLAS, TX 75204
Dallas County (214) 599-2108

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 Gwendoline Mbaku's NPI number?

The NPI number for Gwendoline Mbaku is 1447624853. It was assigned to this individual provider in the NPPES registry on November 23, 2015.

Where is Gwendoline Mbaku located?

Gwendoline Mbaku practices at 3133 E Lemmon Ave, Dallas, TX 75204. The listed phone number is (866) 389-2727.

What is Gwendoline Mbaku's specialty?

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

Is Gwendoline Mbaku enrolled in Medicare?

Yes. Gwendoline Mbaku is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gwendoline Mbaku's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gwendoline Mbaku reassigns Medicare benefits to Legacy Physiatry Group LLC (Plano, TX). The 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 Gwendoline Mbaku's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gwendoline Mbaku was last updated on October 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.