Daniel Louis Fazzino, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA55814 Issued in CA

Practice address

8280 Santa Monica Blvd
West Hollywood, CA 90046-5915

Phone

(203) 217-1746

NPI assigned

Aug 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mercer University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anthony Martin Mills M D a Medical CorporationGroup PAC ID 1456404573, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: danielfazzino@carcmg.allscriptsdirect.net
• Direct secure messaging: danielfazzino@scmmg.allscriptsdirect.net

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.

• Anthony Martin Mills M D a Medical Corporation

  • Internal Medicine Physician
  • West Hollywood, CA
  • NPI 1497172043
  Medicare reassignment Care Compare group
• Men'S Health Foundation

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1356889836
  Medicare reassignment
• Men'S Health Foundation

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1770940306
  NPD

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

{
    "created_epoch": "1534032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1013496892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8280 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465915",
            "telephone_number": "203-217-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8280 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465915",
            "telephone_number": "203-217-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZINO",
        "first_name": "DANIEL",
        "middle_name": "LOUIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-12",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA55814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Michelle Baum Fast, MD
• Mike Fatula, MS, MFT
• Tashifa Fayyaz
• Faza Dietetics LLC
• Mariam Fazel
• Robert Fellin, PHARM.D., BCPS
• Ava Y Feng, M.D.
• Daniel Fenton
• Pamela Ruth Fenton, M.D
• John David Fernandez

• Medical Physician Assistant in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.