IVAN CHE NDAMUKONG PHD, PA-C
NPI 1679234371
Physician Assistant in Portsmouth, VA

Active since January 04, 2022PECOS EnrolledAccepts Medicare Assignment
1040 UNIVERSITY BLVD STE 205, PORTSMOUTH, VA 23703(757) 391-7370 Get Directions Write a Review

NPPES record last updated: August 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 29, 2022, Aug 23, 2022, Jan 4, 2022 (3 updates tracked since 2022).

About Ivan Che Ndamukong Phd, Pa-c NPPES

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

IVAN CHE NDAMUKONG PHD, PA-C (NPI 1679234371) is an individual physician assistant in Portsmouth, Virginia, licensed in Virginia (0110008765) and active in the NPI registry since January 2022. He is enrolled in Medicare PECOS, is affiliated with Bon Secours Maryview Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1679234371
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameIVAN CHE NDAMUKONGCredential: PHD, PA-C
Location Address1040 UNIVERSITY BLVD STE 205Portsmouth, VA 23703-2650
Mailing Address2113 Chesterfield LoopChesapeake, VA 23323-6670 · (252) 412-9548
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJanuary 4, 2022
Last NPPES UpdateAugust 29, 20223 updates tracked since enumeration
NPPES CertifiedAugust 29, 2022
NPI 1679234371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in VA · 0110008765
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1040 UNIVERSITY BLVD STE 205, Portsmouth, VA 23703

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

Ivan Che Ndamukong Phd, Pa-c 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 ID7911378252
PECOS Enrollment IDI20230124000977
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bon Secours Maryview Medical Center

Acute Care Hospitals · Portsmouth, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490017
Location3636 High StreetPortsmouth, VA 23707 · Portsmouth City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23703 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
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 7

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

Physician Assistant
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Obstetrics & Gynecology
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Physician Assistant
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Otolaryngology (Sleep Medicine)
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Internal Medicine
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Internal Medicine (Pulmonary Disease)
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703
Internal Medicine (Pulmonary Disease)
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703

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 Ivan Ndamukong's NPI number?

The NPI number for Ivan Ndamukong is 1679234371. It was assigned to this individual provider in the NPPES registry on January 4, 2022.

Where is Ivan Ndamukong located?

Ivan Ndamukong practices at 1040 University Blvd Ste 205, Portsmouth, VA 23703. The listed phone number is (757) 391-7370.

What is Ivan Ndamukong's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ivan Ndamukong enrolled in Medicare?

Yes. Ivan Ndamukong 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 Ivan Ndamukong accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Ivan Ndamukong 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.

Is Ivan Ndamukong affiliated with any hospitals?

According to CMS data, Ivan Ndamukong is affiliated with Bon Secours Maryview Medical Center.

When was this NPI record last updated?

The NPPES record for Ivan Ndamukong was last updated on August 29, 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.