Khadija Fofana

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01045000 Issued in NJ

Practice address

122 Girard Ave
Somerset, NJ 08873-2417

Phone

(717) 341-8790

NPI assigned

May 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Barnabas Health Medical Group, PCGroup PAC ID 0648172809, 257 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084
• Community Medical Center Hospital, Toms River, NJ, CCN 310041
• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Merit-based Incentive Payment System (MIPS)

Final score

98.51 of 100Reported as apm

Quality

84.27

Promoting interoperability

100

Improvement activities

40

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.

• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  Medicare reassignment Care Compare group NPD
• Blissful Intentions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Toms River, NJ
  • NPI 1144079765
  Medicare reassignment NPD Authorized official
• Minuteclinic Diagnostic of New Jersey LLC

  • Family Nurse Practitioner
  • Sewell, NJ
  • NPI 1053353615
  Medicare reassignment NPD

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

• Community Medical Center Inc

  • General Acute Care Hospital
  • Toms River, NJ
  • NPI 1013010917
  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Lakewood, NJ
  • NPI 1225133473
  Care Compare affiliation
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  Care Compare affiliation

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1407413297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CROOKED STICK RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274032",
            "telephone_number": "609-916-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GIRARD AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732417",
            "telephone_number": "717-341-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOFANA",
        "first_name": "KHADIJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01045000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Finkiel, DNP, PMHNP-BC
• Bahar Fatemeh Firoz, MD, MPH
• Cynthia M. Fisher, M.A. CCC-SLP
• Wayne Fisher, PH.D.
• Justin Fleming, DPM
• Mukhtar Fofana
• Andrea R. Footerman, PSY.D.
• Petal Patricia Forbes
• Forever Young Medical Day Care
• Forever Young Medical Day Care

• Psychiatric/Mental Health Nurse Practitioner in Somerset, NJ
• Providers in Somerset, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.