Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Etienne T Ngoumgna, PA-C, MHSMSC

Individual provider Physician Assistant · NPI 1487891776

Mr. Etienne T Ngoumgna, PA-C, MHSMSC is a Physician Assistant in Baltimore, Maryland. Qualified in 2001, 25 years ago. Practices with St Agnes Healthcare Inc, a 269-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
25
Licensed in
MD
In the registry since
2009
Specialties on file
2
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

821 N Eutaw St Ste 103
Baltimore, MD 21201-4648
Phone: (410) 225-8760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence C0002500 (MD)
Physician Assistant Taxonomy 363A00000X · Licence C0002500 (MD)

Record details

NPI number1487891776
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , MHSMSC
Sole proprietorNo
NPI enumeratedJanuary 8, 2009
Last updated in NPPESJuly 8, 2010

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice St Agnes Healthcare Inc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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