ERNESTINE PENVAGA FOMUNUNG-NGAM (ARNP) – Family Nurse Practitioner, NPI 1104352665
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ERNESTINE PENVAGA FOMUNUNG-NGAM (ARNP)
102 WOODMONT BLVD STE 600
NASHVILLE, TN 372055250
Phone: (888) 987-1151
Type: Mailing
2010 Wellness Way Ste 200
Las Vegas, NV 891064142
Phone: (702) 877-0814
Fax: (702) 877-3238
Type: Location
2010 WELLNESS WAY STE 200
LAS VEGAS, NV 891064142
Phone: (702) 877-0814
Fax: (702) 877-3238
Type: Location
Gall Boulevard, Zephyrhills, Pasco County, Florida, 33542, United States
ZEPHYRHILLS, FL 335422511
Phone: (813) 779-1209
Fax: (813) 779-1216
Type: Location
3830 E FLAMINGO RD STE 100
LAS VEGAS, NV 891216234
Phone: (725) 269-1044
Fax: (725) 712-8163
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: 2020-04-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171004002962 | I | Nurse Practitioner | FL | TBD |
| I20200413000225 | I | Nurse Practitioner | NV | 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 |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 1,397 | 183 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 356 | 129 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 159 | 147 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 98 | 59 | $0 |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 88 | 76 | $0 |
Insurance plans in this area (ZIP 37205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| - | NV | |
| - | NV | |
| - | NV | |
| H E M A T O L O G Y/ O N C O L O G Y | NV | |
| Nurse Practitioner | NV | |
| Nurse Practitioner | NV | |
| - | NV | |
| - | DE | |
| - | NV |
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