Active NPI
Ralph F Fabiani, NP
- Adult Health Nurse Practitioner
- Port Jefferson, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F311316
- Practice address
- 75 N Country Rd
Port Jefferson, NY 11777-2119 - Phone
- (631) 473-1320
- NPI assigned
- Aug 23, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F311316 | NY | Primary |
Addresses
Primary practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Mailing address
575 Bayport Ave
Bayport, NY 11705-1418
Phone (631) 487-1728
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- John T Mather Memorial Hospital
Practice addresses (Care Compare)
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320
Hospital & facility affiliations
- John T Mather Memorial Hospital of Port Jefferson
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311316 | NY | MD | Emergency Medicine Physician |
| F311316 | NY | MD | Adult Health Nurse Practitioner |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John T. Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients |
Locations
100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Organizations & group practices 3
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.
-
- Psychiatry Physician
- Port Jefferson Station, NY
- NPI 1376642371
-
- Critical Care Medicine (Internal Medicine) Physician
- Port Jefferson, NY
- NPI 1467249334
-
- Hospitalist Physician
- Port Jefferson, NY
- NPI 1932296316
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1093718728
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1104600865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 BAYPORT AVE",
"city": "BAYPORT",
"state": "NY",
"postal_code": "117051418",
"telephone_number": "631-487-1728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-473-1320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABIANI",
"first_name": "RALPH",
"middle_name": "F",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F311316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.