Individual provider Active NPI

Faridatu Oheneba Toffa

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1992594840
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP032078 Issued in PA
Practice address
1930 S Broad St Unit 4
Philadelphia, PA 19145-2328
Phone
(610) 647-0330
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 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 SP032078 PA Primary

Addresses

Primary practice location

1930 S Broad St Unit 4
Philadelphia, PA 19145-2328

Mailing address

935 Ruby Cir
Gilbertsville, PA 19525-8415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260306001774 PA Practitioner - Nurse Practitioner 5890277933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

512 E Townshipline Rd
Suite 115
Blue Bell, PA 19422-2700

935 Ruby Cir
Gilbertsville, PA 19525-8415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP032078PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Malvern Constitution LLC CurrentSince Jan 20, 2026 Accepting new patients

Locations

1930 S Broad St
Unit 4
Philadelphia, PA 19145
Phone (610) 502-4674

1930 S Broad St
Unit 17
Philadelphia, PA 19145
Phone (610) 480-8919

Organizations & group practices 1

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": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1992594840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 RUBY CIR",
            "city": "GILBERTSVILLE",
            "state": "PA",
            "postal_code": "195258415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S BROAD ST UNIT 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "610-647-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOFFA",
        "first_name": "FARIDATU",
        "middle_name": "OHENEBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP032078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.