Bonjoe Tazifor

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

36 Tindal Springs CT
Montgomery Village, MD 20886-4908

Phone

(240) 474-7633

NPI assigned

Jan 6, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1285222141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 TINDAL SPRINGS CT",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208864908",
            "telephone_number": "240-474-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 TINDAL SPRINGS CT",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208864908",
            "telephone_number": "240-474-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZIFOR",
        "first_name": "BONJOE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279625494",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "abahomehealth.com",
            "affiliation": "N",
            "address_1": "36 Tindal Springs Ct",
            "city": "Montgomery Village",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208864908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Case Manager/Care Coordinator in Montgomery Village, MD
• Providers in Montgomery Village, MD by specialty
• Case Manager/Care Coordinator in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.