Organization Active NPI

Faisal Rafiq, MD, PC

  • Psychiatry Physician
  • Amityville, NY
National Provider Identifier
1003563560
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FAISAL RAFIQ, MD, PC
Practice address
120 Broadway
Suite D
Amityville, NY 11701
Phone
(631) 440-1010
Fax
(631) 237-5818
NPI assigned
Mar 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Faisal Rafig, MD
Title
Physician
Phone
(631) 440-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

120 Broadway
Suite D
Amityville, NY 11701

Mailing address

120 Broadway
Suite D
Amityville, NY 11701
Phone (718) 924-7444

Other identifiers 1

IdentifierTypeStateIssuer
271401OtherNYMEDICAL LICENSE

Other names 1

  • Psychvisit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address billingdepartment@psychvisit.today Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220308000355 NY Part B Supplier - Clinic/Group Practice 7618361627 Receives reassigned benefits from 6 practitioners
Practice locations: Albany, NY; Amityville, NY; West Babylon, NY

National Provider Directory

National Provider Directory

Locations

120 Broadway
Amityville, NY 11701
Phone (516) 605-7505

120 Broadway
Ste D
Amityville, NY 11701
Phone (631) 440-1010

620 6th St
West Babylon, NY 11704
Phone (631) 440-1010

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1003563560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BROADWAY",
            "address_2": "SUITE D",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "718-924-7444",
            "fax_number": "516-879-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BROADWAY",
            "address_2": "SUITE D",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-440-1010",
            "fax_number": "631-237-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAISAL RAFIQ, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "RAFIG",
        "authorized_official_first_name": "FAISAL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-440-1010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "271401",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billingdepartment@psychvisit.today",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 Broadway Ste D",
            "city": "Amityville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117012762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Psychvisit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Psychvisit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.