Deactivated NPI 1831257831 Deactivated / Inactive NPI Male Practitioner

Dr. Mutombo Kankonde , MD, MPH

Internal Medicine • El Paso, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mutombo Kankonde has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 04, 2006

NPI Deactivation Date April 07, 2020

Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Mutombo Kankonde, MD, MPH was a registered Internal Medicine practicing in El Paso, TX. Throughout an active medical career spanning 14 years, Dr. Kankonde provided care at the practice location at 11601 PELLICANO DR until profile deactivation on 2020-04-07.

Historical Medicare Part B clinical services included established patient outpatient office visit, complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

11601 Pellicano Dr
Suite A2

El Paso, TX 799366279

Telephone 9153073354

Fax 9153073956

Associated Practice Facility / Clinic

🏢 Victor Gomez Vanval Enterprise Facility NPI 1174529945

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in El Paso, TX

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 21.6 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

275 Specialists

Practicing in El Paso, TX (9538 Statewide)

Telehealth Adoption Rate

12.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

70.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	33	25	$360.00	$105.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	394	112	$325.14	$103.47
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	358	104	$36.00	$8.46
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	195	22	$331.23	$99.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	108	24	$138.56	$42.64
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	58	41	$435.76	$139.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	37	23	$462.02	$193.49
99213 Established patient office or other outpatient visit, typically 15 minutes	36	14	$306.10	$68.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$445.85	$156.73
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$507.79	$198.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	609	162	$198.02	$102.95
J1100 Injection, dexamethasone sodium phosphate, 1 mg	474	12	$5.00	$0.12
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	420	129	$36.00	$9.40
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	138	32	$191.96	$98.89
96375 Injection of additional new drug or substance into vein	135	12	$108.00	$17.07
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	115	12	$97.57	$19.38
G9678 Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a	82	23	$165.00	$156.80
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	46	38	$362.48	$190.19
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$326.57	$154.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	201	48	$240.60	$127.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	174	118	$199.56	$102.61
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	168	31	$188.48	$96.71
99213 Established patient office or other outpatient visit, typically 15 minutes	149	106	$128.00	$48.51
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	144	91	$36.00	$10.45
G9678 Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a	60	29	$165.00	$156.80
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	43	16	$32.88	$17.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	36	34	$347.15	$179.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$306.99	$150.72

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License VA 0101051749

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners

Rodolfo Arjon

Durable Medical Equipment & Medical Supplies

NPI 1023319142

Dr. Mikel Anderson , DC

Chiropractor

NPI 1043209174

Doctor of Chiropractic

Dr. Claud Drennan , DC

Chiropractor

NPI 1104007244

Doctor of Chiropractic

Sarah Perez

Occupational Therapist - Pediatrics

NPI 1114259777

Ernie Ruiz

Durable Medical Equipment & Medical Supplies

NPI 1164814356

Edgar Garcia , NP

Nurse Practitioner - Gerontology

NPI 1215800214

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated April 07, 2020

Record deactivated on April 07, 2020

✅

NPI Profile Active February 18, 2014

NPI status registered as active in NPPES database

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Updated Practice Location February 18, 2014

Registered at 11601 PELLICANO DR, SUITE A2, EL PASO, TX 799366279 (Tel: 9153073354)

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Updated Business Mailing Address February 18, 2014

Registered at 11601 PELLICANO DR, SUITE A2, EL PASO, TX 799366279 (Tel: 9153073354)

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Provider Name / Credentials Updated February 18, 2014

Recorded as MUTOMBO KANKONDE, M.D., M.PH.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2014

Internal Medicine (License #0101051749 in VA)

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Initial NPI Registration & Enumeration December 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1831257831

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 04, 2006

Last Update: February 18, 2014

Deactivation Date: April 07, 2020

Update or Correct Profile

Mailing Address

11601 Pellicano Dr, Suite A2

El Paso, TX 799366279

Phone: 9153073354

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.