HENRIETTE N KAMGANG-NOUBISSI (NP) – Family Nurse Practitioner, NPI 1649731563
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for HENRIETTE N KAMGANG-NOUBISSI (NP)
24613, Farmview Lane, Damascus Hill, Duvall Manor, Montgomery County, Maryland, 20872, United States
DAMASCUS, MD 208723301
Phone: (240) 374-3291
Type: Mailing
9318 GAITHER RD STE 205
GAITHERSBURG, MD 208771409
Phone: (301) 820-7200
Fax: (301) 778-7026
Type: Location
19731 EXECUTIVE PARK CIR
GERMANTOWN, MD 208742642
Phone: (301) 540-1332
Type: Mailing
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: 2020-05-07
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200507001265 | I | Nurse Practitioner | DC | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 35 | 35 | $0 |
| 90471 | Administration of vaccine | 32 | 32 | $0 |
| G0008 | Administration of influenza virus vaccine | 13 | 13 | $0 |
Insurance plans in this area (ZIP 20872)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Geriatric Medicine | MD |
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