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MRS. ETHEL MBOMBOW PA-C
NPI 1801121348
Physician Assistant in Eastpointe, MI

Active since October 15, 2009PECOS EnrolledAccepts Medicare Assignment
21409 KELLY RD, SUITE 400, EASTPOINTE, MI 48021(586) 777-0630(586) 777-0631 Get Directions Write a Review

NPPES record last updated: July 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Ethel Mbombow Pa-c NPPES

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

MRS. ETHEL MBOMBOW PA-C (NPI 1801121348) is an individual physician assistant in Eastpointe, Michigan, licensed in Michigan (5601005700) and active in the NPI registry since October 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1801121348
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. ETHEL MBOMBOWCredential: PA-C
Location Address21409 KELLY RD, SUITE 400Eastpointe, MI 48021-3264
Mailing Address4967 Crooks Rd, Ste 130Troy, MI 48098-5801 · (248) 952-1601 · Fax (248) 952-1614
Phone(586) 777-0630
Fax(586) 777-0631
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateOctober 15, 2009
Last NPPES UpdateJuly 29, 2015
✔ NPI 1801121348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601005700
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 5601005700 (MI), 1088784 (MI)
21409 KELLY RD, Eastpointe, MI 48021
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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. Ethel Mbombow 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 ID1456475367
PECOS Enrollment IDI20100830000719
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.

Areas of Expertise CMS Part B claims 3

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.

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.
131 services45 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
20 services15 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.
17 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48021 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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 5

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

DR. SHARON LEILANI MCRAE M.D.
Emergency Medicine
21409 KELLY RD, 400
EASTPOINTE, MI 48021
Macomb County (586) 777-0630
MILLENIUM PAIN MANAGEMENT & THERAPY
Pain Medicine (Pain Medicine)
21409 KELLY RD, STE 400
EASTPOINTE, MI 48021
Macomb County (586) 777-0630
DR. GEORGE J. CARLINO D.D.S.
Dentist (General Practice)
21409 KELLY RD, SUITE 100
EASTPOINTE, MI 48021
Macomb County (586) 772-1414
KATHY NICOLE COOLEY P.A.
Physician Assistant
21409 KELLY RD, SUITE 400
EASTPOINTE, MI 48021
Macomb County (586) 777-0630
INSTACLEAR LABORATORY LLC
Clinical Medical Laboratory
21409 KELLY RD
EASTPOINTE, MI 48021
Macomb County (586) 222-6208

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 Ethel Mbombow's NPI number?

The NPI number for Ethel Mbombow is 1801121348. It was assigned to this individual provider in the NPPES registry on October 15, 2009.

Where is Ethel Mbombow located?

Ethel Mbombow practices at 21409 Kelly Rd Suite 400, Eastpointe, MI 48021. The listed phone number is (586) 777-0630.

What is Ethel Mbombow's specialty?

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

Is Ethel Mbombow enrolled in Medicare?

Yes. Ethel Mbombow 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 Ethel Mbombow accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Priority Health and Providence Health Plan and 1 other insurer list Ethel Mbombow 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 Ethel Mbombow was last updated on July 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.