DR. LUTHER MANGOBA M.D.
NPI 1528041894
Family Medicine in Riverside, CA

Active since November 21, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 05D1094983 · Waiver
9041 MAGNOLIA AVE, SUITE 008, RIVERSIDE, CA 92503(951) 687-0004(951) 687-0080 Get Directions Write a Review

NPPES record last updated: July 3, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Luther Mangoba M.d. NPPES

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

DR. LUTHER MANGOBA M.D. (NPI 1528041894) is an individual family medicine provider in Riverside, California, licensed in California (A77574) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through January 29, 2027, and is a graduate of Loma Linda University School Of Medicine (2000).

NPPES Registry Identity

NPI1528041894
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. LUTHER MANGOBACredential: M.D.
Location Address9041 MAGNOLIA AVE, SUITE 008Riverside, CA 92503-3900
Mailing Address9041 Magnolia Ave, Suite 008Riverside, CA 92503-3900 · (951) 687-0004 · Fax (951) 687-0080
Fax(951) 687-0080
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2000
Enumeration DateNovember 21, 2005
Last NPPES UpdateJuly 3, 2014
NPI 1528041894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · A77574
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9041 MAGNOLIA AVE, Riverside, CA 92503

Other Identifiers 4

Medicare ID-Type Unspecified00A775740CA
OtherA77574CA · State Licencse
Medicare UPINI24482CA
Medicaid00A775740CA

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. Luther Mangoba 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 ID2466403860
PECOS Enrollment IDI20050202000963
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1094983

Luther Mangoba MD Inc · Riverside, CA
Active · expires Jan 29, 2027
CLIA Number05D1094983
Laboratory TypePhysician Office
Certificate Effective DateJanuary 30, 2025
Certificate Expiration DateJanuary 29, 2027
Laboratory DirectorLuther B. Mangoba MD
Laboratory Phone(951) 687-0004
Laboratory LocationLuther Mangoba MD Inc9041 Magnolia Ave Ste 008, Riverside, CA 92503
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 19

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.

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
672 services122 patients
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.
199 services100 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.
113 services81 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
102 services48 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
70 services61 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.
61 services61 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92503 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

Referred Medical Equipment & Supplies CMS DME claims 19

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
2 suppliers11 claims11 services$6.61 avg. paid by Medicare
Urinary catheter anchoring device, adhesive skin attachment, each A4333
DME-Orthotic Devices · category DF000N
1 supplier11 claims132 services$2.13 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier11 claims22 services$9.36 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
1 supplier51 claims8,076 services$0.37 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier11 claims525 services$0.21 avg. paid by Medicare
Collagen based wound filler, dry form, sterile, per gram of collagen A6010
DME-Medical/Surgical Supplies · category DA023N
3 suppliers16 claims510 services$29.96 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.

Optometrist
9041 MAGNOLIA AVE
RIVERSIDE, CA 92503
Specialist
9041 MAGNOLIA AVE, SUITE 107
RIVERSIDE, CA 92503
Clinic/Center (Urgent Care)
9041 MAGNOLIA AVE, SUITE 107
RIVERSIDE, CA 92503
Internal Medicine
9041 MAGNOLIA AVE, SUITE 302
RIVERSIDE, CA 92503
General Practice
9041 MAGNOLIA AVE, SUITE 107
RIVERSIDE, CA 92503
Family Medicine
9041 MAGNOLIA AVE, SUITE 105B
RIVERSIDE, CA 92503
Ophthalmology
9041 MAGNOLIA AVE, SUITE 207
RIVERSIDE, CA 92503
Specialist
9041 MAGNOLIA AVE, 206
RIVERSIDE, CA 92503

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 Luther Mangoba's NPI number?

The NPI number for Luther Mangoba is 1528041894. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Where is Luther Mangoba located?

Luther Mangoba practices at 9041 Magnolia Ave Suite 008, Riverside, CA 92503. The listed phone number is (951) 687-0004.

What is Luther Mangoba's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Luther Mangoba enrolled in Medicare?

Yes. Luther Mangoba 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.

Does Luther Mangoba hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1094983) is associated with this NPI, valid through January 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Luther Mangoba was last updated on July 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.