Eli Foryang Mbeufonjoh, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

256548 Issued in AZ

Practice address

1201 S 7TH Ave
Phoenix, AZ 85007-3913

Phone

(602) 416-7600

NPI assigned

Sep 2, 2020

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

Medicare fee-for-service enrollment

Enrolled in AZ, PA, WA3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connectionsaz LLCGroup PAC ID 3072858745, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eli.mbeufonjoh@mmconnections.contexture.medalliesmail.com

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.

• Connectionsaz, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1083840953

  Single Specialty

  Medicare reassignment Care Compare group NPD
• K&E Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1487303053

  Single Specialty

  Medicare reassignment NPD Authorized official
• Connectionspa LLC

  • Adult Mental Health Clinic/Center
  • Harrisburg, PA
  • NPI 1952141889
  Medicare reassignment
• Connectionswa, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkland, WA
  • NPI 1114607140
  Medicare reassignment
• Connectionsaz, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1972985547
  NPD

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1407460983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 S WALLRADE LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961494",
            "telephone_number": "908-477-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850073913",
            "telephone_number": "602-416-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBEUFONJOH",
        "first_name": "ELI",
        "middle_name": "FORYANG",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MD",
            "license": "R217419",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "256548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095691",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Leroy MC Dowell, PA

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.