TINA DIBOFO
NPI 1184571069
Nurse Practitioner - Psychiatric/Mental Health in Novi, MI

Q: What is Tina Dibofo's NPI number?

The NPI number for Tina Dibofo is 1184571069. It was assigned to this individual provider in the NPPES registry on March 11, 2026.

Q: What is Tina Dibofo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tina Dibofo was last updated on March 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 11, 2026PECOS Enrolled

39465 W 14 MILE RD, NOVI, MI 48377(877) 906-9699 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 18, 2026, Mar 11, 2026 (2 updates tracked since 2026).

On this page

About Tina Dibofo NPPES

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

TINA DIBOFO (NPI 1184571069) is an individual psychiatric/mental health provider in Novi, Michigan, licensed in Illinois (209034913) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1184571069

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameTINA DIBOFO

Location Address39465 W 14 MILE RDNovi, MI 48377-1600

Mailing Address39465 W 14 Mile RdNovi, MI 48377-1600

Phone(877) 906-9699

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 11, 2026

Last NPPES UpdateMarch 18, 20262 updates tracked since enumeration

NPPES CertifiedMarch 18, 2026

✔ NPI 1184571069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LP0808X

License✔ Licensed in IL · 209034913

39465 W 14 MILE RD, Novi, MI 48377

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tina Dibofo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971088907

PECOS Enrollment IDI20260327002511

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 48377 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

Leave this field empty