Individual provider Active NPI

Nicholas Faberowski, MD

  • Ophthalmology Physician
  • San Jose, CA
National Provider Identifier
1073536157
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
44086 Issued in CO
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5000
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 44086 CO Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604

Other practice location 1

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Other identifiers 1

IdentifierTypeStateIssuer
68800878MedicaidCO

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170309001833 CA Practitioner - Ophthalmology 4688693583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Duke University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44086COMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jan 24, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Ophthalmology CurrentSince Jan 24, 2017 Accepting new patients
Reichert Eye Centers of N FL, PA Ophthalmology Past Accepting new patients
Columbia Eye Associates PA Ophthalmology PastSince Dec 1, 2003 Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

751 S Bascom Ave
Bldg Q
San Jose, CA 95128
Phone (408) 885-6770

751 S Bascom Ave
Fl 3
San Jose, CA 95128
Phone (408) 358-2511

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/K8KD7A7C
  • Direct secure messaging: nfaberowski66284@santaclaravalley.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1073536157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282604",
            "country_code": "US",
            "telephone_number": "408-885-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FABEROWSKI",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "44086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68800878",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.