Active NPI
Priscilla Isabella Ampofo, FNP
- Family Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 343872
- Practice address
- 1275 York Ave
New York, NY 10065-6007 - Phone
- (212) 639-2000
- NPI assigned
- Feb 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 343872 | NY | Primary |
Addresses
Primary practice location
1275 York Ave
New York, NY 10065-6007
Mailing address
111 Hollister St
Stratford, CT 06615-6230
Phone (718) 300-5978
Other names 1
- Priscilla Isabella Ampofo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
111 Hollister St
Stratford, CT 06615-6230
200 Oceangate
Suite 100
Long Beach, CA 90802-4316
200 Oceangate
Suite 100
Long Beach, CA 90802-4317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13120 | CT | MD | Clinical Social Worker |
| 343872 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molina Care Connections, LLC. | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- pampofo40158@mskcc.direct-ci.com
- pampofo20719@direct-prd.molinahealthcare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549584000000",
"number": "1053876409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HOLLISTER ST",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066156230",
"telephone_number": "718-300-5978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656007",
"telephone_number": "212-639-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMPOFO",
"first_name": "PRISCILLA",
"middle_name": "ISABELLA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-08",
"last_updated": "2019-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "343872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PRISCILLA",
"last_name": "AMPOFO",
"middle_name": "ISABELLA",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.