LARISSA FOMUM MUGRI MD
NPI 1851973721
Student in an Organized Health Care Education/Training Program in Chicago, IL
About Larissa Fomum Mugri Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LARISSA FOMUM MUGRI MD (NPI 1851973721) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center-northeast, and is a graduate of Michigan State University College Of Human Medicine (2021).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Larissa Fomum Mugri Md 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 Larissa Fomum Mugri reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Statesville, NC 28677
- Reassigned Medicare billing, North Carolina enrollment
- 580 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.
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Carolinas Medical Center-Northeast
Acute Care Hospitals · Concord, NCAtrium Health University City
Acute Care Hospitals · Charlotte, NCOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHICAGO, IL 60637
CHICAGO, IL 60637
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 Larissa Fomum Mugri's NPI number?
The NPI number for Larissa Fomum Mugri is 1851973721. It was assigned to this individual provider in the NPPES registry on April 21, 2021.
Where is Larissa Fomum Mugri located?
Larissa Fomum Mugri practices at 5841 S Maryland Ave # Mc5068, Chicago, IL 60637. The listed phone number is (773) 702-9109.
What is Larissa Fomum Mugri's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Larissa Fomum Mugri enrolled in Medicare?
Yes. Larissa Fomum Mugri 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 Larissa Fomum Mugri's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Larissa Fomum Mugri reassigns Medicare benefits to Wake Forest Emergency Providers (Statesville, NC). 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 Larissa Fomum Mugri's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Larissa Fomum Mugri accept?
Health plans from Oscar Health Plan of North Carolina, Inc list Larissa Fomum Mugri 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 Larissa Fomum Mugri affiliated with any hospitals?
According to CMS data, Larissa Fomum Mugri is affiliated with Carolinas Medical Center-Northeast and Atrium Health University City.
When was this NPI record last updated?
The NPPES record for Larissa Fomum Mugri was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Larissa Fomum Mugri, MD · NPI 1851973721
Student in an Organized Health Care Education/Training Program provider in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since April 21, 2021.
## Identity
- **NPI:** 1851973721 (Entity type: Individual)
- **Enumerated:** April 21, 2021
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5841 S MARYLAND AVE # MC5068, Chicago, IL 60637-1443
- **Phone:** (773) 702-9109
## 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:** Wake Forest Emergency Providers (NPI 1396216735, Statesville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Michigan State University College Of Human Medicine, class of 2021
## Record status
- **NPPES last updated:** April 21, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1851973721) · Data from the CMS NPPES public registry.