KUMBIRAI MADIYE PMHNP
NPI 1427563535
Nurse Practitioner - Psychiatric/Mental Health in Laguna Beach, CA
NPI Status: Active since December 12, 2017
Contact Information
MINDWORKS CONNECTION
1968 S COAST HWY # 4560
LAGUNA BEACH, CA
ZIP 92651
Phone: (425) 615-4312
Fax: (442) 253-8085
- Individual
- Female
- Nurse Practitioner
- Psychiatric/Mental Health
- Accepts Insurance
- PECOS Enrolled
About KUMBIRAI MADIYE
This page provides the complete NPI Profile along with additional information for Kumbirai Madiye, a provider established in Laguna Beach, California with a medical specialization in Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1427563535 assigned on December 2017. The practitioner's primary taxonomy code is 363LP0808X with license number 95008989 (CA). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1427563535
- Provider Name
- KUMBIRAI MADIYE PMHNP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- MINDWORKS CONNECTION 1968 S COAST HWY # 4560 LAGUNA BEACH, CA 92651
- Location Phone
- (425) 615-4312
- Location Fax
- (442) 253-8085
- Mailing Address
- 1968 S COAST HWY # 4560 LAGUNA BEACH, CA 92651
- Mailing Phone
- (425) 615-4312
- Mailing Fax
- (442) 253-8085
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-12-2017
- Last Update Date
- 04-07-2022
- Code Navigator
A nurse practitioner (NP) like Kumbirai Madiye is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 95008989
- License State
- CA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | AP61108955 (WA) |
| 2 | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 228169 (AZ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver (Select) - HMO
- Bronze Classic Standard (Select) - HMO
- Gold Classic (Select) - HMO
- Gold Classic Standard (Select) - HMO
- Gold Elite Saver Plus (Select) - HMO
- Secure (Select) - HMO
- Silver Classic Standard (Select) - HMO
- Silver Elite Saver Plus (Select) - HMO
- Silver Simple Chronic Care CKM (Select) - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple PCP Saver - HMO
- Bronze Classic PCP Saver - HMO
- Bronze Classic Standard - HMO
- Bronze Simple HSA - HMO
- Gold Classic Standard - HMO
- Gold Elite - HMO
- Gold Elite Saver Plus - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Chronic Care CKM - HMO
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Kumbirai Madiye is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
This is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 18 times for 12 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 92651 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $96.36
- Minimum New Patient Price $62.96
- Maximum New Patient Price $187.6
- Average New Patient Copayment $24.09
- Minimum New Patient Copayment $15.74
- Maximum New Patient Copayment $46.9
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $109.96
- Minimum Established Patient Price $20.84
- Maximum Established Patient Price $153.61
- Average Established Patient Copayment $27.49
- Minimum Established Patient Copayment $5.21
- Maximum Established Patient Copayment $38.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 5 | 6 | 3 | 5 | 3 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 10 | 6 | 6 | 5 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 1 + 0 + 6 + 6 + 5 + 6 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1427563535 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1417604422 | MINDWORKS CONNECTION PROFESSIONAL NURSING CORPORATION Organization | Clinic/Center (Mental Health (Including Community Mental Health Center)) | MINDWORKS CONNECTION 1968 S COAST HWY # 4560 LAGUNA BEACH, CA 92651 (425) 615-4312 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427563535, enumerated in the NPI registry as an "individual" on December 12, 2017
The provider is located at Mindworks Connection 1968 S Coast Hwy # 4560 Laguna Beach, Ca 92651 and the phone number is (425) 615-4312
The provider's speciality is Nurse Practitioner with taxonomy code 363LP0808X with a focus in Psychiatric/Mental Health
The provider might be accepting Accepts: Aetna CVS Health, BannerAetna, Oscar Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $96.36 with an average copayment of $24.09 for new patient appointments. Established patients should expect a typical charge of $109.96 and an average copayment of 27.49. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes.
This NPI record was last updated on December 12, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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