MRS. EREWARIFAGHA MININI HAIDOME PMHNP-BC
NPI 1114301728
Nurse Practitioner - Psychiatric/Mental Health in Jamaica, NY

Q: What is Erewarifagha Haidome's NPI number?

The NPI number for Erewarifagha Haidome is 1114301728. It was assigned to this individual provider in the NPPES registry on July 13, 2015. The provider is also known as Miss Erewari Minini Peterside Nurse Practitioner.

Q: What is Erewarifagha Haidome's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since July 13, 2015PECOS EnrolledAccepts Medicare Assignment

14036 170TH ST, JAMAICA, NY 11434(347) 843-7760 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 2, 2023, Feb 1, 2022 (2 updates tracked since 2022).

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About Mrs. Erewarifagha Minini Haidome Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. EREWARIFAGHA MININI HAIDOME PMHNP-BC (NPI 1114301728) is an individual psychiatric/mental health provider in Jamaica, New York, licensed in New York (403564) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1114301728

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMRS. EREWARIFAGHA MININI HAIDOMECredential: PMHNP-BC

Location Address14036 170TH STJamaica, NY 11434-4632

Mailing Address3963 Murdock AveBronx, NY 10466-2442 · (347) 281-0304

Phone(347) 843-7760

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 13, 2015

Last NPPES UpdateNovember 2, 20232 updates tracked since enumeration

NPPES CertifiedNovember 2, 2023

✔ NPI 1114301728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · 403564

Also ListedRegistered NurseTaxonomy 163W00000X · License 621055-1 (NY)

14036 170TH ST, Jamaica, NY 11434

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Other Names 1

Professional Name (2)Miss Erewari Minini Peterside Nurse Practitioner

Secondary Practice Locations 2

Location 1391 E 149th St Rm 405Bronx, NY 10455-3907 · Phone (718) 215-1117

Location 2256 Washington StMount Vernon, NY 10553-1052 · Phone (914) 613-0700 ext. 7041

Other Identifiers 1

Other1114301728NY · Npi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Erewarifagha Minini Haidome Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911399845

PECOS Enrollment IDI20220126001024

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11434 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$116.96 typical visit price

range $21.62 – $163.52

Typical copayment $29.24 (range $5.40 – $40.88)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIMISAC FAMILY HEALTH NP PC

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