Individual provider Active NPI

Momgoh Roland Tifuh

  • Case Manager/Care Coordinator
  • Lanham, MD
National Provider Identifier
1093534083
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6554 Princess Garden Pkwy
Lanham, MD 20706-3533
Phone
(240) 305-9701
NPI assigned
Oct 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

6554 Princess Garden Pkwy
Lanham, MD 20706-3533

Mailing address

6554 Princess Garden Pkwy
Lanham, MD 20706-3533
Phone (240) 305-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1093534083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6554 PRINCESS GARDEN PKWY",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063533",
            "telephone_number": "240-305-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6554 PRINCESS GARDEN PKWY",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063533",
            "telephone_number": "240-305-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFUH",
        "first_name": "MOMGOH",
        "middle_name": "ROLAND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.