Jamie Lois Lorenzo Fabros

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045722 Issued in NY

Practice address

8046 Kew Gardens Rd
Kew Gardens, NY 11415-1154

Phone

(718) 261-1000

NPI assigned

Oct 16, 2023

Sex

Female

Sole proprietor

Yes

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 IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Yasam Health LLC

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1134524549
  Medicare reassignment

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1073395158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E 37TH ST RM 310",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163256",
            "telephone_number": "212-951-0430",
            "fax_number": "212-951-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8046 KEW GARDENS RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151154",
            "telephone_number": "718-261-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABROS",
        "first_name": "JAMIE LOIS",
        "middle_name": "LORENZO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jed Edison Mance Evangelista, PT
• Vea Eunice Gestiada Evangelista, PT
• Eye Lab Optician PC
• Eyedeal Optometry, PC
• Eyeglass Liquidators Inc.
• Kayrene Farmer
• Julia Fassler
• Natella Fazylov, RPH
• Evelyn Lucy Fazylova, PHARMD
• Carlos A Fernandez

• Physical Therapist in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.