Sunny Besong Diffang, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R202090 Issued in MD

Practice address

3523 Corn Stream Rd
Randallstown, MD 21133-2442

Phone

(410) 528-3866

NPI assigned

Feb 24, 2020

Last updated

Feb 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 DC, MD2 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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdiffang185527@direct.aahs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luminis Health Medical Group, LLC

  dba Luminis Health Maternal and Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  dba Annapolis Surgical Oncology Associates

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485

  DC

  Medicare reassignment NPD
• Axis Healthcare Group

  dba CareMind Health

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1326295098
  Medicare reassignment
• Advanced Behavioral Health Solutions - LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Burnie, MD
  • NPI 1154993350
  Authorized official Same address or phone
• Luminis Health Medical Group, LLC

  dba Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Annapolis, MD
  • NPI 1285953182
  NPD
• Luminis Health Medical Group, LLC

  dba Luminis Health Heart Surgery Lanham

  • Cardiovascular Disease Physician
  • Lanham, MD
  • NPI 1609739101
  NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1407480817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 CORN STREAM RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332442",
            "telephone_number": "410-528-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 CORN STREAM RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332442",
            "telephone_number": "410-528-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFFANG",
        "first_name": "SUNNY",
        "middle_name": "BESONG",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R202090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destilee Health Care
• Mike Destine
• Julija Jael Devance
• Dharani Jasthi DMD PC (Today's Dental Associates)
• Jennifer Diaz, LMSW
• Mario Klimentov Dimitrov, PA-C
• Shalini Dimple, OTR/L
• Divine Mercy Holistic Care
• Divine Wellness Inc
• Ata Dizdar

• Psychiatric/Mental Health Nurse Practitioner in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.