Peter C Fan, AUDIOLOGIST (AUD)

Primary specialty

AudiologistTaxonomy code 231H00000X

License

41YA00099800 Issued in NJ

Practice address

200 Perrine Rd Ste 210
Old Bridge, NJ 08857-2836

Phone

(914) 333-5801

NPI assigned

Jun 19, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Audiologist

Education

University of Florida College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advance Audiology Care

  • Audiologist
  • Old Bridge, NJ
  • NPI 1659982403
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1003077405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD STE 210",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572836",
            "telephone_number": "914-333-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD STE 210",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572836",
            "telephone_number": "914-333-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "AUDIOLOGIST (AUD)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00099800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excel Urgent Care of NJ LLC
• Sandra Fahmy, D.O.
• Ronald William Falcon, MD
• Family Eye Care of Old Bridge, PC
• Family One Enterprises, Inc.
• Daniel Fanouse, DO
• Farida Ali DDS LLC
• Khadija Farooq, DO
• Feola Foot and Ankle Associates, LLC
• Thomas John Feola, DPM

• Audiologist in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.