Individual provider Active NPI

Hassan Mohamed Fares, N.P.

  • Adult Health Nurse Practitioner
  • Cheektowaga, NY
National Provider Identifier
1083790430
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304167 Issued in NY
Practice address
3884 Broadway St
Cheektowaga, NY 14227-1104
Phone
(716) 681-9000
NPI assigned
Oct 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304167 NY Primary

Addresses

Primary practice location

3884 Broadway St
Cheektowaga, NY 14227-1104

Mailing address

226 N Creek Dr
Cheektowaga, NY 14225-4440
Phone (716) 903-4575

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070517000059 NY Practitioner - Nurse Practitioner 0840397402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adult Medical Services PCGroup PAC ID 3173579547, 3 clinicians

Practice addresses (Care Compare)

6645 Main St
Suite a
Williamsville, NY 14221-5994
Phone (716) 276-8726

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F304167NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Medical Services, P.C. CurrentSince Mar 13, 2007 Accepting new patients

Locations

3884 Broadway St
Cheektowaga, NY 14227
Phone (716) 681-9000

8167 Sheridan Dr
#100
Williamsville, NY 14221
Phone (716) 276-8726

6645 Main St
Ste A
Williamsville, NY 14221
Phone (716) 276-8726

Organizations & group practices 1

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 3

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083790430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 N CREEK DR",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254440",
            "telephone_number": "716-903-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3884 BROADWAY ST",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142271104",
            "telephone_number": "716-681-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARES",
        "first_name": "HASSAN",
        "middle_name": "MOHAMED",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

Verify at the official NPI Registry.