Individual provider Active NPI

Khadijat Momoh

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1841061819
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN03370 Issued in RI
Practice address
6 Barone CT
Providence, RI 02904-1286
Phone
(512) 363-0793
NPI assigned
Jan 9, 2024
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN03370 RI Primary

Addresses

Primary practice location

6 Barone CT
Providence, RI 02904-1286

Mailing address

6 Barone CT
Providence, RI 02904-1286

Other practice location 1

100 Crossing Blvd Ste 300
Framingham, MA 01702-5555
Phone (888) 964-6681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240510002259 RI Practitioner - Nurse Practitioner 4587005301 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians
Value Based Long Term Care H PCGroup PAC ID 4587104641, 145 clinicians

Practice addresses (Care Compare)

135 Dodge St
Providence, RI 02907-2210
Phone (888) 964-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Nurse Practitioner CurrentSince Feb 1, 2026 Accepting new patients
Medicine and Long Term Care Associates, LLC CurrentSince May 1, 2024 Accepting new patients
Healthdrive Medical Services Southeast LLC Nurse Practitioner CurrentSince Feb 1, 2026 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

333 Budlong Rd
Cranston, RI 02920
Phone (401) 943-4530

135 Dodge St
Providence, RI 02907
Phone (401) 383-5150

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1841061819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BARONE CT",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BARONE CT",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041286",
            "telephone_number": "512-363-0793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Crossing Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017025555",
            "country_code": "US",
            "telephone_number": "888-964-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMOH",
        "first_name": "KHADIJAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN03370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.