John Matthew Fay, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD20060672 Issued in NM

Practice address

3917 West Road
Suite a Mannm
Los Alamos, NM 87544

Phone

(505) 661-8900

Fax

(505) 661-8916

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Los Alamos Physician Practices LLC

  • Family Medicine Physician
  • Los Alamos, NM
  • NPI 1750330510
  NPD (past)
• Catholic Health Initiatives Colorado

  • Rural Health Clinic/Center
  • Canon City, CO
  • NPI 1568604437
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1104888783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST ROAD",
            "address_2": "SUITE A MANNM",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST ROAD",
            "address_2": "SUITE A MANNM",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR44193",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD20060672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53123877",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianna Katherine Lange Evans, LMHC
• Steven E Evans, M.D.
• Expressive Arts Project LLC
• Eye Associates of New Mexico, LTD.
• Elver Fajardo del Cid, PHARM D
• Lori Anne Fay, DO
• Seth M Felice, D.P.M.
• Katy Fellows
• Rique Natasha Fernandez-Lymon
• Ann K Ferris, M.D.

• Family Medicine Physician in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.