Dave Ofori, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404427 Issued in NY

Practice address

3425 Vernon Blvd
Long Island City, NY 11106-5121

Phone

(718) 726-8484

NPI assigned

Sep 22, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

New York University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Houses of Long Island IncGroup PAC ID 4880584101, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoenix Houses of Long Island, Inc.

  • Substance Abuse Rehabilitation Facility
  • Brentwood, NY
  • NPI 1174691281

  Single Specialty

  Medicare reassignment Care Compare group NPD
• J&D Ultracare Corp

  • Home Health Agency
  • Suffern, NY
  • NPI 1659442051
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1043769789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111065121",
            "telephone_number": "718-726-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111065121",
            "telephone_number": "718-726-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Suffern Place",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Suffern",
            "state": "NY",
            "postal_code": "10901",
            "country_code": "US",
            "telephone_number": "845-357-4500 x123",
            "fax_number": "845-357-5039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFORI",
        "first_name": "DAVE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "721801",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Omoyemwen Susan Odigie, RN
• Melissa Odom
• Elizabeth Oduro
• Edith Oluchi Ogbenna, FNP
• Ifeoma O Ogu
• Jieun Oh
• Rachel Owens Okabe, M.D.
• Edna Okang, RN

• Psychiatric/Mental Health Nurse Practitioner in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.