Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hamutyinei H Mamutse

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1033742184

Hamutyinei H Mamutse is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2019, 7 years ago. Practices with Extended Care Specialists, Inc, a 290-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2020
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Practice location Address checks out

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone: (260) 483-9081
Fax: (260) 483-9196
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN.CNP.026184 (OH)

Record details

NPI number1033742184
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 18, 2020
Last updated in NPPESFebruary 18, 2020
Certification dateFebruary 18, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Extended Care Specialists, Inc — 290 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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