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Kenneth Elad Fonguck

NPI 1265028781ActiveIndividual· Nurse Practitioner, Psych/Mental Health· Woonsocket, RI

Nurse Practitioner, Psych/Mental Health in Woonsocket, Rhode Island, licensed in GA, with an NPI issued in December 2020.

Overview

NPI1265028781
StatusActive
Entity typeIndividual
Sole proprietorYes
NPI issuedDec 18, 2020
Last updated in NPPESMar 19, 2026
Certified by providerMar 19, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Nurse Practitioner, Psych/Mental Health Primary363LP0808XAPRN-NP296175GA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026No match—
New York OMIG · Nov 4, 2026No match—
Ohio Medicaid · Nov 4, 2026No match—
Pennsylvania Medicheck · Nov 4, 2026No match—
Washington HCA · Nov 4, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

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