MUTIATU MODUPE MOIBI
NPI 1831999176
Nurse Practitioner - Psychiatric/Mental Health in Chicago, IL
About Mutiatu Modupe Moibi NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MUTIATU MODUPE MOIBI (NPI 1831999176) is an individual psychiatric/mental health provider in Chicago, Illinois, licensed in Illinois (209030990) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mutiatu Modupe Moibi 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.
Medicare Billing Reassignment
Medicare enrollment records show Mutiatu Moibi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Burr Ridge, IL 60527
- Reassigned Medicare billing, Illinois enrollment
- 183 clinicians in this Medicare group
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 60640 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Mutiatu Moibi's NPI number?
The NPI number for Mutiatu Moibi is 1831999176. It was assigned to this individual provider in the NPPES registry on March 17, 2025.
Where is Mutiatu Moibi located?
Mutiatu Moibi practices at 4621 N Racine Ave, Chicago, IL 60640. The listed phone number is (773) 784-2300.
What is Mutiatu Moibi's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mutiatu Moibi enrolled in Medicare?
Yes. Mutiatu Moibi 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.
Which organization bills Medicare for Mutiatu Moibi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mutiatu Moibi reassigns Medicare benefits to Paragon Clinical LLC (Burr Ridge, IL). 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 Mutiatu Moibi'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 Mutiatu Moibi was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Mutiatu Modupe Moibi · NPI 1831999176
Psychiatric/Mental Health physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since March 17, 2025.
## Identity
- **NPI:** 1831999176 (Entity type: Individual)
- **Enumerated:** March 17, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 209030990 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 4621 N RACINE AVE, Chicago, IL 60640-4905
- **Phone:** (773) 784-2300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Paragon Clinical LLC (NPI 1114139946, Burr Ridge, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 17, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1831999176) · Data from the CMS NPPES public registry.