Momentom Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MOMENTOM WELLNESS LLC

Practice address

1336 Main St
Osterville, MA 02655-1542

Phone

(508) 237-5886

NPI assigned

Jun 28, 2021

Last updated

Dec 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diane Ofria, MS, RN, FPMHNP-BCNPI 1396077665

Title

Owner/Sole Member

Phone

(508) 237-5886

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane M Ofria, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hyannis, MA
  • NPI 1396077665
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1871163261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "city": "OSTERVILLE",
            "state": "MA",
            "postal_code": "026552031",
            "telephone_number": "508-237-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 MAIN ST",
            "city": "OSTERVILLE",
            "state": "MA",
            "postal_code": "026551542",
            "telephone_number": "508-237-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTOM WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "OFRIA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "508-237-5886",
        "authorized_official_credential": "MS, RN, FPMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Osterville, MA
• Providers in Osterville, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.