Maseray Fofanah, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1068830 Issued in TX

Practice address

1717 W Northern Ave Ste 211
Phoenix, AZ 85021-5469

Phone

(480) 249-2655

NPI assigned

Mar 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Qofl Services LLCGroup PAC ID 6709030133, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Qofl Services LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1942554837

  PA

  Medicare reassignment Care Compare group NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  PA

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  PA

  Medicare reassignment NPD
• Peaceful Hearts Staffing Solutions LLC

  • Home Health Agency
  • Media, PA
  • NPI 1780490078
  NPD Authorized official
• Grand Services and More LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1336885912
  NPD

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1215638465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 N STATE RD APT 25A",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190641826",
            "telephone_number": "161-076-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 211",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215469",
            "telephone_number": "480-249-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOFANAH",
        "first_name": "MASERAY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1068830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Focused Family Services LLC
• Focused Living Health Services
• Focusing on You Mental Health LLC
• Mary Lorraine Foehringer, NP
• Ronald A. Foeldi, D.D.S.
• Mary Ann Fogarty, RN
• Kelly Fogel
• Natalie Chantall Fogelson, PT, CLT-LANA
• Rowan Fogerty, DMD
• Christine M. Fogg, RN.

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.