MASERAY FOFANAH FNP
NPI 1215638465
Nurse Practitioner - Family in Phoenix, AZ
About Maseray Fofanah Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MASERAY FOFANAH FNP (NPI 1215638465) is an individual family provider in Phoenix, Arizona, licensed in Texas (1068830) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, is affiliated with Holy Redeemer Hospital And Medical Center, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Maseray Fofanah Fnp 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.
Medicare Billing Reassignments
3Medicare enrollment records show Maseray Fofanah reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dallas, TX 75244
- Reassigned Medicare billing, Pennsylvania enrollment
- 553 clinicians in this Medicare group
Louisville, KY 40207
- Reassigned Medicare billing, Pennsylvania enrollment
- 26 clinicians in this Medicare group
Columbia, MD 21045
- Reassigned Medicare billing, Pennsylvania enrollment
- 24 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Holy Redeemer Hospital And Medical Center
Acute Care Hospitals · Meadowbrook, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHOENIX, AZ 85021
PHOENIX, AZ 85021
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Maseray Fofanah's NPI number?
The NPI number for Maseray Fofanah is 1215638465. It was assigned to this individual provider in the NPPES registry on March 14, 2023.
Where is Maseray Fofanah located?
Maseray Fofanah practices at 1717 W Northern Ave Ste 211, Phoenix, AZ 85021. The listed phone number is (480) 249-2655.
What is Maseray Fofanah's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Maseray Fofanah enrolled in Medicare?
Yes. Maseray Fofanah is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Maseray Fofanah's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maseray Fofanah reassigns Medicare benefits to 3 organizations: Signify Health Medical Associates, PLLC (Dallas, TX), Qofl Services LLC (Louisville, KY) and Provider Partners Care Management LP (Columbia, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maseray Fofanah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Maseray Fofanah affiliated with any hospitals?
According to CMS data, Maseray Fofanah is affiliated with Holy Redeemer Hospital And Medical Center.
When was this NPI record last updated?
The NPPES record for Maseray Fofanah was last updated on March 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Maseray Fofanah, FNP · NPI 1215638465
Family physician in Phoenix, Arizona. Individual provider, active in the CMS NPPES registry since March 14, 2023.
## Identity
- **NPI:** 1215638465 (Entity type: Individual)
- **Enumerated:** March 14, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1068830 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1717 W NORTHERN AVE STE 211, Phoenix, AZ 85021-5469
- **Phone:** (480) 249-2655
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX); Qofl Services LLC (NPI 1942554837, Louisville, KY); Provider Partners Care Management LP (NPI 1013348028, Columbia, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** March 14, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1215638465) · Data from the CMS NPPES public registry.