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

Licemee Mbama-Mpolo

Individual provider Family Nurse Practitioner · NPI 1285401687

Licemee Mbama-Mpolo is a Nurse Practitioner in Rochester, New York. Qualified in 2024, 2 years ago. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2023
Specialties on file
2

Practice location Address checks out

1415 Portland Ave Ste 245
Rochester, NY 14621-3022
Phone: (585) 922-4496
Fax: (585) 922-4442
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 355355 (NY)
Maternal Newborn Registered Nurse Taxonomy 163WM0102X · Licence 797276 (NY)

Record details

NPI number1285401687
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 6, 2023
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Rochester