Individual provider Active NPI

Moufditi Jean Philippe Lerebours, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1699282152
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406229 Issued in NY
Practice address
1265 Franklin Ave
Bronx, NY 10456-3501
Phone
(718) 992-7669
NPI assigned
Jan 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 406229 NY Primary
Family Nurse Practitioner 363LF0000X F342102 NY

Addresses

Primary practice location

1265 Franklin Ave
Bronx, NY 10456-3501

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3467
Phone (718) 992-7669

Other practice location 1

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 299-7295

Other practice location 2

150 Liberty Pkwy Apt C12
Spring Valley, NY 10977-5341
Phone (845) 416-2396

Other practice location 3

150 Liberty Pkwy Apt C12
Spring Valley, NY 10977-5341
Phone (845) 416-2396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190228000613 NY Practitioner - Nurse Practitioner 9335488857 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F342102NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Apr 1, 2021 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 8, 2019 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Bronxcare Health System CurrentSince Apr 1, 2021 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Jan 8, 2019 Accepting new patients
Essen Medical Associates,PC CurrentSince Jan 8, 2019 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Jan 8, 2019 Accepting new patients

Locations

1265 Franklin Ave
Fl 6
Bronx, NY 10456

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1265 Franklin Ave
Bronx, NY 10456
Phone (718) 503-7700

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: moufditi.jean.phillippe.lerebours.1@24989.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1699282152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563467",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 FRANKLIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563501",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10453",
            "country_code": "US",
            "telephone_number": "718-299-7295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Liberty Pkwy Apt C12",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "NY",
            "postal_code": "109775341",
            "country_code": "US",
            "telephone_number": "845-416-2396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Liberty Pkwy Apt C12",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "NY",
            "postal_code": "109775341",
            "country_code": "US",
            "telephone_number": "845-416-2396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEREBOURS",
        "first_name": "MOUFDITI",
        "middle_name": "JEAN PHILIPPE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406229",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.