MRS. MIRABEL TIBUJI MAMBO
NPI 1639888092
Nurse Practitioner - Psychiatric/Mental Health in Elk River, MN
About Mrs. Mirabel Tibuji Mambo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. MIRABEL TIBUJI MAMBO (NPI 1639888092) is an individual psychiatric/mental health provider in Elk River, Minnesota, licensed in Minnesota (9433) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted 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
Mrs. Mirabel Tibuji Mambo 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55330 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Mirabel Mambo's NPI number?
The NPI number for Mirabel Mambo is 1639888092. It was assigned to this individual provider in the NPPES registry on November 15, 2022.
Where is Mirabel Mambo located?
Mirabel Mambo practices at 19097 Baldwin St NW, Elk River, MN 55330. The listed phone number is (763) 328-4738.
What is Mirabel Mambo's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mirabel Mambo enrolled in Medicare?
Yes. Mirabel Mambo 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 Mirabel Mambo accept?
Health plans from HealthPartners list Mirabel Mambo 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 Mirabel Mambo was last updated on November 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mrs. Mirabel Tibuji Mambo · NPI 1639888092
Psychiatric/Mental Health physician in Elk River, Minnesota. Individual provider, active in the CMS NPPES registry since November 15, 2022.
## Identity
- **NPI:** 1639888092 (Entity type: Individual)
- **Enumerated:** November 15, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 9433 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 19097 BALDWIN ST NW, Elk River, MN 55330-2813
- **Phone:** (763) 328-4738
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** November 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1639888092) · Data from the CMS NPPES public registry.