Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tina Dibofo

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1184571069

Tina Dibofo is a Nurse Practitioner in Novi, Michigan. Qualified in 2023, 3 years ago. Practices with Bcs of Illinois, SC, a 3-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2026

Practice location Address checks out

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone: (877) 906-9699
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209034913 (IL)

Record details

NPI number1184571069
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 11, 2026
Last updated in NPPESMarch 18, 2026
Certification dateMarch 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Bcs Of Illinois, S.C. — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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