Ernestine Penvaga Fomunung-ngam, ARNP - Medicare Nurse Practitioner in Las Vegas, NV

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Ernestine Penvaga Fomunung-ngam, ARNP is a medicare enrolled "Nurse Practitioner - Family" in Las Vegas, Nevada. Her current practice location is 2010 Wellness Way Ste 200, Las Vegas, Nevada. You can reach out to her office (for appointments etc.) via phone at (702) 877-0814.

Ernestine Penvaga Fomunung-ngam is licensed to practice in Florida (license number ARNP9310637) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104352665.

Contact Information

Ernestine Penvaga Fomunung-ngam, ARNP
2010 Wellness Way Ste 200,
Las Vegas, NV 89106-4142
(702) 877-0814
(702) 877-3238

Map and Direction




Provider's Profile

Full NameErnestine Penvaga Fomunung-ngam
GenderFemale
SpecialityNurse Practitioner - Family
Location2010 Wellness Way Ste 200, Las Vegas, Nevada
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104352665
  • Provider Enumeration Date: 05/03/2017
  • Last Update Date: 07/27/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3779858501
  • Enrollment ID: I20200413000225

Medical Identifiers

Medical identifiers for Ernestine Penvaga Fomunung-ngam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104352665NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family ARNP9310637 (Florida)Primary
363L00000XNurse Practitioner ARNP9310637 (Florida)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ernestine Penvaga Fomunung-ngam allows following entities to bill medicare on her behalf.
Entity NameOptum Medical Group Rhodes P C
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063458594
PECOS PAC ID: 1052390036
Enrollment ID: O20040714000813
Entity NameSignify Health Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20191002002008
Entity NamePremium Healthcare Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982379590
PECOS PAC ID: 0547667966
Enrollment ID: O20230131002634
Entity NameComprehensive Rehab Consultants Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710529771
PECOS PAC ID: 6800220682
Enrollment ID: O20230220001059

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ernestine Penvaga Fomunung-ngam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ernestine Penvaga Fomunung-ngam, ARNP
6748 Gall Blvd,
Zephyrhills, FL 33542-2511

Ph: (813) 779-1209		Ernestine Penvaga Fomunung-ngam, ARNP
2010 Wellness Way Ste 200,
Las Vegas, NV 89106-4142

Ph: (702) 877-0814

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.