Active NPI
David Fayngersh, M. D.
- Pediatrics Physician
- West New York, NJ
National Provider Identifier
1124082532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA068124
- Practice address
- 5301 Broadway
West New York, NJ 07093-2622 - Phone
- (201) 866-9320
- Fax
- (201) 867-9183
- NPI assigned
- Apr 13, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA068124 | NJ | Primary |
Addresses
Primary practice location
5301 Broadway
West New York, NJ 07093-2622
Mailing address
1440 12TH St
Fort Lee, NJ 07024-2004
Phone (201) 242-1747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8406006 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA068124 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Hudson Community Action Corporation | Past | Accepting new patients | |
| North Hudson Community Action Corp.Health Center | Past | Accepting new patients | |
| HMH Hospitals Corporation | Past | Accepting new patients | |
| HMH Hospitals Corporation | Past | Accepting new patients | |
| North Hudson Community Action Corporation | Past | Accepting new patients | |
| North Hudson Community Action Corporation | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- General Acute Care Hospital
- Hackensack, NJ
- NPI 1457456279
-
- General Acute Care Hospital
- North Bergen, NJ
- NPI 1730692344
-
- Federally Qualified Health Center (FQHC)
- Union City, NJ
- NPI 1427362078
-
- Federally Qualified Health Center (FQHC)
- Secaucus, NJ
- NPI 1043465057
-
- Federally Qualified Health Center (FQHC)
- Union City, NJ
- NPI 1548626005
-
- Federally Qualified Health Center (FQHC)
- West New York, NJ
- NPI 1659323442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1124082532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 12TH ST",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070242004",
"telephone_number": "201-242-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 BROADWAY",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070932622",
"telephone_number": "201-866-9320",
"fax_number": "201-867-9183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAYNGERSH",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA068124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8406006",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West New York, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.