Organization Active NPI

Fyk Med PLLC

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1124522792
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FYK MED PLLC
Practice address
10238 E Hampton Ave
Mesa, AZ 85209-3316
Phone
(480) 354-6463
NPI assigned
Mar 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Dr. Fayz Yar Khan, MDNPI 1043476096
Title
Owner
Phone
(480) 823-1199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10238 E Hampton Ave
Mesa, AZ 85209-3316

Mailing address

12746 N Windrose Dr
Scottsdale, AZ 85260-4534
Phone (480) 823-1199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180802001778 AZ Part B Supplier - Clinic/Group Practice 2466700760 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

10238 E Hampton Ave
Mesa, AZ 85209
Phone (480) 357-0366

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1124522792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12746 N WINDROSE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604534",
            "telephone_number": "480-823-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10238 E HAMPTON AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093316",
            "telephone_number": "480-354-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FYK MED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "YAR KHAN",
        "authorized_official_first_name": "FAYZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-823-1199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.