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MUBANGU MADO MANDAMUNA
NPI 1588333033
Nurse Practitioner - Family in Champaign, IL

Active since September 08, 2021PECOS Enrolled
201 N RANDOLPH ST, CHAMPAIGN, IL 61820(877) 726-6494 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 24, 2026, Dec 29, 2022, Sep 8, 2021 (3 updates tracked since 2021).

About Mubangu Mado Mandamuna NPPES

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

MUBANGU MADO MANDAMUNA (NPI 1588333033) is an individual family provider in Champaign, Illinois, licensed in Illinois (209023791) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588333033
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMUBANGU MADO MANDAMUNA
Location Address201 N RANDOLPH STChampaign, IL 61820-3935
Mailing Address3723 Summer Sage CtChampaign, IL 61822-1907
Phone(877) 726-6494
Sole ProprietorNo
Enumeration DateSeptember 8, 2021
Last NPPES UpdateJuly 24, 20263 updates tracked since enumeration
NPPES CertifiedJuly 24, 2026
✔ NPI 1588333033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IL · 209023791✔ Licensed in MS · 907367
Also ListedFamily Medicine · Hospice and Palliative MedicineTaxonomy 207QH0002X · License 209023791 (IL)
201 N RANDOLPH ST, Champaign, IL 61820
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mubangu Mado Mandamuna 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 Reassignments

4

Medicare enrollment records show Mubangu Mandamuna reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Molina Healthcare Of California
1,674 mi
Family Medicine
887 E SECOND ST
Pomona, CA 91766
  • Reassigned Medicare billing, California enrollment
  • 339 clinicians in this Medicare group
NPI 1932214228 (909) 620-7769
Central Health Plan Of California, Inc.
1,680 mi
Health Maintenance Organization
1540 BRIDGEGATE DR
Diamond Bar, CA 91765
  • Reassigned Medicare billing, California enrollment
  • 283 clinicians in this Medicare group
NPI 1386714772 (626) 388-2390
Molina Care Connections, LLC.
1,706 mi
Nurse Practitioner
200 OCEANGATE STE 100
Long Beach, CA 90802
  • Reassigned Medicare billing, Illinois and Mississippi enrollments
  • 74 clinicians in this Medicare group
NPI 1407243223 (888) 562-5442
Molina Healthcare Of Washington, Inc
1,758 mi
Family Medicine
21540 30TH DR SE STE 400
Bothell, WA 98021
  • Reassigned Medicare billing, Washington enrollment
  • 207 clinicians in this Medicare group
NPI 1659897163 (888) 562-5442

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 61820 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUZETTE ANN ASTELL-RICHARDSON APRN
Nurse Practitioner (Family)
201 N RANDOLPH ST
CHAMPAIGN, IL 61820
Champaign County (877) 726-6494

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 Mubangu Mandamuna's NPI number?

The NPI number for Mubangu Mandamuna is 1588333033. It was assigned to this individual provider in the NPPES registry on September 8, 2021.

Where is Mubangu Mandamuna located?

Mubangu Mandamuna practices at 201 N Randolph St, Champaign, IL 61820. The listed phone number is (877) 726-6494.

What is Mubangu Mandamuna's specialty?

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

Is Mubangu Mandamuna enrolled in Medicare?

Yes. Mubangu Mandamuna is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mubangu Mandamuna's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mubangu Mandamuna reassigns Medicare benefits to 4 organizations: Molina Healthcare Of California (Pomona, CA), Central Health Plan Of California, Inc. (Diamond Bar, CA), Molina Care Connections, LLC. (Long Beach, CA) and Molina Healthcare Of Washington, Inc (Bothell, WA). 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 Mubangu Mandamuna'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 Mubangu Mandamuna was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.