Active NPI
Natalya B Faynboym, MD
- Physical Medicine & Rehabilitation Physician
- Peoria, AZ
National Provider Identifier
1154312403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 34352
- Practice address
- 9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381-4847 - Phone
- (623) 523-6560
- Fax
- (623) 523-6581
- NPI assigned
- Nov 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 34352 | AZ | Primary |
| Physical Medicine & Rehabilitation Physician | 208100000X | 2007-00545 | NC |
Addresses
Primary practice location
9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381-4847
Mailing address
13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5907194 | Medicaid | NC | |
| Q45007 | Medicaid | SC | |
| 1154312403 | Medicaid | VA | |
| 968505 | Medicaid | AZ | |
| 3810009395 | Medicaid | WV |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007-00545 | NC | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270598400000",
"number": "1154312403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13640 N PLAZA DEL RIO BLVD",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814846",
"telephone_number": "623-876-3800",
"fax_number": "623-876-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9165 W THUNDERBIRD RD",
"address_2": "STE 100",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814847",
"telephone_number": "623-523-6560",
"fax_number": "623-523-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAYNBOYM",
"first_name": "NATALYA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-03",
"last_updated": "2010-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "AZ",
"license": "34352",
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NC",
"license": "2007-00545",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5907194",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q45007",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154312403",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "968505",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810009395",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.