MRS. ALIMATA SORE OUEDRAOGO APN
NPI 1639778301
Nurse Practitioner - Psychiatric/Mental Health in Jersey City, NJ

Q: What is Alimata Sore Ouedraogo's NPI number?

The NPI number for Alimata Sore Ouedraogo is 1639778301. It was assigned to this individual provider in the NPPES registry on October 22, 2020.

Q: What is Alimata Sore Ouedraogo's specialty?

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

Active since October 22, 2020PECOS Enrolled

176 PALISADE AVE, JERSEY CITY, NJ 07306(201) 795-8200 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 13, 2026, Apr 3, 2023, Oct 22, 2020 (3 updates tracked since 2020).

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About Mrs. Alimata Sore Ouedraogo Apn NPPES

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

MRS. ALIMATA SORE OUEDRAOGO APN (NPI 1639778301) is an individual psychiatric/mental health provider in Jersey City, New Jersey, licensed in New Jersey (26NJ01068900) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Newark.

NPPES Registry Identity

NPI1639778301

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMRS. ALIMATA SORE OUEDRAOGOCredential: APN

Location Address176 PALISADE AVEJersey City, NJ 07306

Mailing Address2333 Morris Ave Ste C202Union, NJ 07083-5747 · (201) 795-8200

Phone(201) 795-8200

Sole ProprietorNo

Enumeration DateOctober 22, 2020

Last NPPES UpdateAugust 13, 20263 updates tracked since enumeration

NPPES CertifiedAugust 13, 2026

✔ NPI 1639778301 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 NJ · 26NJ01068900

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 26NJ01068900 (NJ)

176 PALISADE AVE, Jersey City, NJ 07306

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Secondary Practice Location 1

Location 1550 Broad St Ste 606Newark, NJ 07102-4537 · Phone (201) 822-1161 · Fax (877) 485-8918

Other Identifiers 1

Medicaid0773093NJ

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Alimata Sore Ouedraogo Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Alimata Sore Ouedraogo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Garden State Healthcare Associates, LLC

5.7 mi

Emergency Medicine

29 E 29TH ST
Bayonne, NJ 07002

Reassigned Medicare billing, New Jersey enrollment
637 clinicians in this Medicare group

NPI 1700014545 (844) 242-7436

Jls Medical PC

6.3 mi

Psychiatry

550 BROAD ST STE 606
Newark, NJ 07102

Reassigned Medicare billing, New Jersey enrollment
141 clinicians in this Medicare group

NPI 1164007043 (201) 822-1161

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07306 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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 20

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

MR. JACOB HERNANDEZ LAC

Marriage & Family Therapist