Evelyn Ndafooka, PMHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11227 Issued in WI

Practice address

2321 Stout Rd
Menomonie, WI 54751-7003

Phone

(715) 838-5222

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
• Mayo Clinic Health System Chippewa Valley Hospital, Bloomer, WI, CCN 521314
• Mayo Clinic Health System-Red Cedar Inc Hospital, Menomonie, WI, CCN 521340
• Mayo Clinic Health System-Northland Hospital, Barron, WI, CCN 521315

Medicare enrollment (NPD)

Enrolled

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.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Medicare reassignment NPD
• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • La Crosse, WI
  • NPI 1659977866
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD
• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1104549047
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Care Compare affiliation
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • General Acute Care Hospital
  • Eau Claire, WI
  • NPI 1629027578
  Care Compare affiliation
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Care Compare affiliation
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  Care Compare affiliation

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1336815190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 STOUT RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547517003",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3703 Oakwood Hills Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547014458",
            "country_code": "US",
            "telephone_number": "534-444-4562",
            "fax_number": "534-444-4563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDAFOOKA",
        "first_name": "EVELYN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "1122733",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "endafooka22638@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2321 Stout Rd",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547517003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasen L Myers, PHARMD
• Connie Nadler, CCC-A/SLP
• Cara Nagel, MS CCC-SLP
• Richard D Nagler, MD
• National Birth Centers Inc
• Lynnae Nehring, COTA
• Rachael Lynn Nellessen
• Carrie Jo Nelson, M.D.
• Justin Nelson, LAT
• Edward Newton, APNP

• Nurse Practitioner in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.