IRENE MUTUA (FNP-C) – Family Medicine Physician, NPI 1811795792

IRENE MUTUA (FNP-C) is a healthcare provider. based in Puyallup, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. AP61667413 (WA). The NPI Number for IRENE MUTUA (FNP-C) is 1811795792

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
IRENE MUTUA (FNP-C)
NPI
1811795792
Phone
(314) 629-9062
Address
11033 191ST STREET CT E
Enumeration Date
5 March 2025
Last Update Date
5 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2535843577
Graduation Year
2024 (2 years ago)
PAC ID
2062939929
Group Practice PAC ID
1850292681
Professional Enrollment ID
I20250505003026
Address ID
WA984993724LA4903XSWXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for IRENE MUTUA (FNP-C)

  • 11033 191ST STREET CT E

    PUYALLUP, WA 983746522

    Phone: (314) 629-9062

    Type: Mailing

  • 4903 108TH ST SW

    LAKEWOOD, WA 984993724

    Phone: (253) 589-6484

    Fax: (253) 984-1079

    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: 2025-05-05

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
I20250505003026INurse PractitionerWATBD

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 98374)

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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: 1850292681View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerTX
Nurse PractitionerWA

Reviews

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Frequently asked questions

What is the standard ID for IRENE MUTUA (FNP-C) in the U.S.?
In the U.S., IRENE MUTUA (FNP-C) is identified by NPI 1811795792.
Should I treat IRENE MUTUA (FNP-C) as an active provider?
Patients and plans typically see IRENE MUTUA (FNP-C) as active in the national extract.
How should patients interpret IRENE MUTUA (FNP-C)'s specialty?
The extract shows Family Medicine Physician for IRENE MUTUA (FNP-C). Clinical services aligned with this taxonomy classification.
What city is tied to IRENE MUTUA (FNP-C)?
The directory associates IRENE MUTUA (FNP-C) with Puyallup, Washington. Check all listed addresses for suites or satellite offices.
Who maintains IRENE MUTUA (FNP-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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