MOLINE MVUNDURA – Student in an Organized Health Care Education/Training Program, NPI 1093403107

MOLINE MVUNDURA is a healthcare provider. based in Plainfield, Indiana. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 28254278A (IN). The NPI Number for MOLINE MVUNDURA is 1093403107

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MOLINE MVUNDURA
NPI
1093403107
Phone
Not provided
Address
2675 CHALBURY DR
Enumeration Date
26 April 2023
Last Update Date
14 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2198652141
Graduation Year
2025 (1 year ago)
PAC ID
1052803194
Group Practice PAC ID
1153576905
Professional Enrollment ID
I20251125003385
Address ID
IN463111705DY24XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

522 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IA

Provider Addresses for MOLINE MVUNDURA

  • 2675 CHALBURY DR

    PLAINFIELD, IN 461687810

    Phone:

    Type: Mailing

  • 200 HAWKINS DR

    IOWA CITY, IA 522421009

    Phone: (319) 384-7354

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251125003385ICertified Registered Nurse Anesthetist (Crna)INTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46168)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153576905View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YIL
Certified Registered Nurse Anesthetist (Crna)IN
Certified Registered Nurse Anesthetist (Crna)IN
A N E S T H E S I O L O G YIN
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YKY
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)IN

Reviews

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Frequently asked questions

Can I cross-check MOLINE MVUNDURA using NPI 1093403107?
NPI 1093403107 belongs to MOLINE MVUNDURA; compare other details if you need extra assurance.
Active or inactive — what applies to MOLINE MVUNDURA?
You should see MOLINE MVUNDURA as active in CMS-hosted NPPES data.
What clinical focus is listed for MOLINE MVUNDURA?
At a glance, MOLINE MVUNDURA is tied to Student in an Organized Health Care Education/Training Program. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MOLINE MVUNDURA?
Travel planning: use Plainfield, Indiana as the reference point for MOLINE MVUNDURA, then confirm.
When was this NPI issued?
Enumeration for MOLINE MVUNDURA is noted as April 26, 2023 where the registry provides it.

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