BONTU GUDETA KENTIBA ARNP
NPI 1902640105
Nurse Practitioner - Adult Health in Lacey, WA
About Bontu Gudeta Kentiba Arnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BONTU GUDETA KENTIBA ARNP (NPI 1902640105) is an individual adult health provider in Lacey, Washington, licensed in Washington (AP70057059) and active in the NPI registry since June 2024. The provider is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
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
Bontu Gudeta Kentiba Arnp 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 98503 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 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LACEY, WA 98503
LACEY, WA 98503
LACEY, WA 98503
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 Bontu Kentiba's NPI number?
The NPI number for Bontu Kentiba is 1902640105. It was assigned to this individual provider in the NPPES registry on June 21, 2024.
Where is Bontu Kentiba located?
Bontu Kentiba practices at 605 Woodland Square Loop SE, Lacey, WA 98503. The listed phone number is (360) 764-8000.
What is Bontu Kentiba's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Bontu Kentiba enrolled in Medicare?
Yes. Bontu Kentiba 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.
When was this NPI record last updated?
The NPPES record for Bontu Kentiba was last updated on October 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Bontu Gudeta Kentiba, ARNP · NPI 1902640105
Adult Health physician in Lacey, Washington. Individual provider, active in the CMS NPPES registry since June 21, 2024.
## Identity
- **NPI:** 1902640105 (Entity type: Individual)
- **Enumerated:** June 21, 2024
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** AP70057059 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 605 WOODLAND SQUARE LOOP SE, Lacey, WA 98503-1045
- **Phone:** (360) 764-8000
## 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 2025
## Record status
- **NPPES last updated:** October 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1902640105) · Data from the CMS NPPES public registry.