NPIMap

Individual provider Active NPI

Gavriel Fuzaylov, MD

  • Internal Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1154332310
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200199 Issued in NY
Practice address
10210 66TH Rd Ste 1H
Forest Hills, NY 11375-2047
Phone
(718) 897-0327
Fax
(844) 965-9107
NPI assigned
Aug 11, 2006
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200199 NY Primary

Addresses

Primary practice location

10210 66TH Rd Ste 1H
Forest Hills, NY 11375-2047

Mailing address

10210 66TH Rd Ste 1H
Forest Hills, NY 11375-2047
Phone (718) 897-0327

Other identifiers 1

IdentifierTypeStateIssuer
01586676MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100209000638 NY Practitioner - Internal Medicine 1951444264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10210 66TH Rd
Suite 1H
Forest Hills, NY 11375-2047
Phone (718) 897-0327

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rego Park Medical Associate,P.C CurrentSince Nov 29, 2009 Accepting new patients
Forest View Nursing Home, Inc. Past Accepting new patients
Forest Hills Care Center Past Accepting new patients

Locations

10210 66th Rd
Ste 1H
Forest Hills, NY 11375
Phone (718) 897-0327

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

9851 Queens Blvd
Ste 1D
Rego Park, NY 11374
Phone (718) 747-8698

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gfuzaylov@fuzaylov.directmedgenehr.com

Organizations & group practices 3

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1154332310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10210 66TH RD STE 1H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752047",
            "telephone_number": "718-897-0327",
            "fax_number": "844-965-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 66TH RD STE 1H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752047",
            "telephone_number": "718-897-0327",
            "fax_number": "844-965-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUZAYLOV",
        "first_name": "GAVRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "200199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01586676",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.