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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MIMA FONDONG
NPI 1609563584
Internal Medicine in Atlanta, GA

Active since April 20, 2023PECOS Enrolled
720 WESTVIEW DR SW, ATLANTA, GA 30310(832) 808-3664 Get Directions Write a Review

NPPES record last updated: October 8, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mima Fondong NPPES

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

MIMA FONDONG (NPI 1609563584) is an individual internal medicine provider in Atlanta, Georgia, licensed in Georgia (111325) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In New Orleans (2023).

NPPES Registry Identity

NPI1609563584
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMIMA FONDONG
Location Address720 WESTVIEW DR SWAtlanta, GA 30310-1458
Mailing Address1311 Mcmurtry Ridge DrKaty, TX 77494-4080 · (832) 808-3664
Phone(832) 808-3664
Sole ProprietorYes
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2023
Enumeration DateApril 20, 2023
Last NPPES UpdateOctober 8, 2026
NPPES CertifiedOctober 8, 2026
✔ NPI 1609563584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 111325
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
720 WESTVIEW DR SW, Atlanta, GA 30310
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mima Fondong is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971061847
PECOS Enrollment IDI20260820003281
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 Mima Fondong reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medlife Healthcare LLC
40 mi
Family Medicine
2129 FRIENDSHIP RD STE 200
Flowery Branch, GA 30542
  • Reassigned Medicare billing, Georgia enrollment
  • 24 clinicians in this Medicare group
NPI 1558974709 (770) 209-2787

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 30310 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.

BRYAN OSAYAMHEN OKOSUN
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1500
UGOCHI GLADYS ANANABA
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1500
DR. THEODORA CHIDERA ABAH MD
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1400
DR. ALEX WALEED MOHAMMAD ALQUDAH MD
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 756-1341
YOG VAGHANI
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1500
BRADFORD ZACHARY GRANT
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1500
NIRVANA ALLISON DURBAL
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 752-1500
IVANNA ALEXIS WARD DO
Student in an Organized Health Care Education/Training Program
720 WESTVIEW DR SW
ATLANTA, GA 30310
Fulton County (404) 756-1383

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 Mima Fondong's NPI number?

The NPI number for Mima Fondong is 1609563584. It was assigned to this individual provider in the NPPES registry on April 20, 2023.

Where is Mima Fondong located?

Mima Fondong practices at 720 Westview Dr SW, Atlanta, GA 30310. The listed phone number is (832) 808-3664.

What is Mima Fondong's specialty?

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

Is Mima Fondong enrolled in Medicare?

Yes. Mima Fondong is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mima Fondong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mima Fondong reassigns Medicare benefits to Medlife Healthcare LLC (Flowery Branch, GA). 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 Mima Fondong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mima Fondong accept?

Health plans from Alliant Health Plans, Inc. list Mima Fondong 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.

When was this NPI record last updated?

The NPPES record for Mima Fondong was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.