Organization Active NPI

Sherif a. Farag, MD, PC

  • Gastroenterology Physician
  • Staten Island, NY
National Provider Identifier
1063786283
Registry record updated Aug 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
213601 Issued in NY
Legal business name
SHERIF A. FARAG, MD, PC
Practice address
5091 Amboy Rd
Staten Island, NY 10312-4722
Phone
(718) 948-0221
Fax
(718) 948-1787
NPI assigned
Mar 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2022

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

Authorized official

Name
Dr. Sherif A. Farag, MDNPI 1861467250
Title
Owner
Phone
(718) 948-0221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 213601 NY Primary

Addresses

Primary practice location

5091 Amboy Rd
Staten Island, NY 10312-4722

Mailing address

5091 Amboy Rd
Staten Island, NY 10312-4722
Phone (718) 948-0221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000057 NY Part B Supplier - Clinic/Group Practice 1254588155 Receives reassigned benefits from 3 practitioners
Practice locations: Staten Island, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1019024Sherif a Farag MD PC5091 Amboy Road, Staten Island, NY 10312ComplianceMar 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659744000000",
    "number": "1063786283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5091 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124722",
            "telephone_number": "718-948-0221",
            "fax_number": "718-948-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5091 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124722",
            "telephone_number": "718-948-0221",
            "fax_number": "718-948-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIF A. FARAG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A",
        "authorized_official_last_name": "FARAG",
        "authorized_official_first_name": "SHERIF",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-948-0221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "213601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.