Individual provider Active NPI

Kareen Mankah Fobuzie

  • Family Nurse Practitioner
  • New Carrollton, MD
National Provider Identifier
1982114518
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00766700 Issued in NJ
Practice address
8606 Preston St
New Carrollton, MD 20784-2850
Phone
(770) 912-8608
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00766700 NJ Primary

Addresses

Primary practice location

8606 Preston St
New Carrollton, MD 20784-2850

Mailing address

8606 Preston St
New Carrollton, MD 20784-2850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20231219000564 NJ Practitioner - Nurse Practitioner 0042660953 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Dec 1, 2023 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

500 Frank W Burr Blvd
Ste 560
Teaneck, NJ 07666

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1982114518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 PRESTON ST",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207842850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8606 PRESTON ST",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207842850",
            "telephone_number": "770-912-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOBUZIE",
        "first_name": "KAREEN",
        "middle_name": "MANKAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00766700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carrollton, MD

Sources for this page

Verify at the official NPI Registry.