Individual provider Active NPI

Arinze P Ejiofor

  • Psychiatric/Mental Health Nurse Practitioner
  • North Andover, MA
National Provider Identifier
1699236034
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP2278347 Issued in MA
Practice address
799 Turnpike St
North Andover, MA 01845-6130
Phone
(978) 226-4508
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP2278347 MA Primary

Addresses

Primary practice location

799 Turnpike St
North Andover, MA 01845-6130

Mailing address

799 Turnpike St
North Andover, MA 01845-6130
Phone (781) 771-8242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20200413002963 MA Practitioner - Nurse Practitioner 8123458239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Square Behavioral Health LLCGroup PAC ID 1759790462, 3 clinicians

Practice addresses (Care Compare)

733 Turnpike St
Suite 162
North Andover, MA 01845-6137

799 Turnpike St
North Andover, MA 01845-6130
Phone (978) 226-4508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP2278347MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Square Behavioral Health, LLC Psychiatric/Mental Health CurrentSince May 3, 2021 Accepting new patients
Evenpath Treatment Center LLC CurrentSince Feb 2, 2025 Accepting new patients

Locations

733 Turnpike St
#162
North Andover, MA 01845
Phone (781) 771-8242

799 Turnpike St
North Andover, MA 01845
Phone (781) 771-8242

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1699236034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 TURNPIKE ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456130",
            "telephone_number": "781-771-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 TURNPIKE ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456130",
            "telephone_number": "978-226-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIOFOR",
        "first_name": "ARINZE",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "CNP2278347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.