Patricia Maforngwahfor Tala

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R224410 Issued in MD

Practice address

9135 Piscataway Rd Ste 410
Clinton, MD 20735-2555

Phone

(240) 643-1063

NPI assigned

Jun 3, 2024

Sex

Female

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 MD

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, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Standard Healthcare Plus LLC

  • Multi-Specialty Clinic/Center
  • Clinton, MD
  • NPI 1245050038
  Medicare reassignment NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1609617703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 BIRDIE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746068",
            "telephone_number": "240-486-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD STE 410",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352555",
            "telephone_number": "240-643-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALA",
        "first_name": "PATRICIA",
        "middle_name": "MAFORNGWAHFOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R224410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergenix Diagnostics
• Synergy Medical Group LLC
• Synergy Medical Group LLC
• Synergy Medical Group LLC
• Omar Taha, M.D.
• Claudette Elizabeth Talley
• Pooja Tanna, MD
• Mirabel Efundem Tanyi
• Lilian Tarke
• Sharon J Tavares

• Psychiatric/Mental Health Nurse Practitioner in Clinton, MD
• Providers in Clinton, 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 Jun 3, 2024; 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.