ISAAC NDUNGU (CNP) – Gerontology Nurse Practitioner, NPI 1174900690

ISAAC NDUNGU (CNP) is a healthcare provider. based in West springfield, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. RN2283072 (MA). The NPI Number for ISAAC NDUNGU (CNP) is 1174900690

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
ISAAC NDUNGU (CNP)
NPI
1174900690
Phone
(413) 592-1980
Address
103 MYRON ST
Enumeration Date
5 May 2015
Last Update Date
5 May 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4437994247
Graduation Year
2014 (12 years ago)
PAC ID
6709197494
Group Practice PAC ID
1951764471
Professional Enrollment ID
I20250820005208
Address ID
MD211332047RA3934XCIRX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:11State licenses:1Digital endpointsOther names

8,972 NURSE PRACTITIONER in MA

Provider Addresses for ISAAC NDUNGU (CNP)

  • 103 MYRON ST

    SUITE A

    WEST SPRINGFIELD, MA 010891598

    Phone: (413) 592-1980

    Mailing address matches the actual address.

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: 2025-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20150622002598INurse PractitionerMATBD
I20250820005208INurse PractitionerMDTBD

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 01089)

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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: 1951764471View full group profile
NameSpecialtyState
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD

Reviews

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Frequently asked questions

Can I use this page to confirm ISAAC NDUNGU (CNP)'s NPI?
Yes. ISAAC NDUNGU (CNP) is listed with NPI 1174900690 in the public NPI dataset.
Is ISAAC NDUNGU (CNP) still practicing?
ISAAC NDUNGU (CNP) is currently listed as active in the public NPI registry.
What taxonomy line describes ISAAC NDUNGU (CNP)?
For research purposes, treat ISAAC NDUNGU (CNP) as Gerontology Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect ISAAC NDUNGU (CNP) on a map?
Expect West Springfield, Massachusetts as a primary anchor for ISAAC NDUNGU (CNP) unless the record lists multiple sites.
Is the information about ISAAC NDUNGU (CNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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