Active NPI
Joseph Fanous, MD
- Psychiatry Physician
- Staten Island, NY
National Provider Identifier
1154010700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 205886
- Practice address
- 355 Bard Ave Dept of
Staten Island, NY 10310-1664 - Phone
- (661) 303-5503
- NPI assigned
- May 1, 2023
- Last updated
- Nov 18, 2025
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 205886 | CA | Primary |
Addresses
Primary practice location
355 Bard Ave Dept of
Staten Island, NY 10310-1664
Mailing address
355 Bard Ave Dept of
Staten Island, NY 10310-1664
Phone (661) 303-5503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5121 Stockdale Hwy
Bakersfield, CA 93309-2656
Phone (661) 868-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205886 | CA | MD | Psychiatry Physician |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Kern BHRS Westchester
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bakersfield, CA
- NPI 1568658821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1154010700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BARD AVE DEPT OF",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "661-303-5503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVE DEPT OF",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103101664",
"telephone_number": "661-303-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANOUS",
"first_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-01",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "205886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.