Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bamoyo Nkongolo, PA-C

Individual provider Physician Assistant · NPI 1962559500

Bamoyo Nkongolo, PA-C is a Physician Assistant in Baltimore, Maryland. Qualified in 2005, 21 years ago. Practices with Mnr Industries, LLC, a 143-clinician group. Licensed in Maryland.

Years since qualifying
21
Licensed in
MD
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone: (410) 550-0100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0003263 (MD)

Record details

NPI number1962559500
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Mnr Industries, Llc — 143 clinicians
Accepts Medicare assignment Not indicated
Practice locations17 on file with Medicare

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