Individual provider Active NPI

Delina Lila Fajardo, RPA-C

  • Physician Assistant
  • Far Rockaway, NY
National Provider Identifier
1154414100
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007052 Issued in NY
Practice address
1612 Central Ave Ste 201
Far Rockaway, NY 11691-4002
Phone
(718) 831-2755
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007052 NY Primary

Addresses

Primary practice location

1612 Central Ave Ste 201
Far Rockaway, NY 11691-4002

Mailing address

3343 Port Royale Dr S Apt 101
Ft Lauderdale, FL 33308-7933
Phone (201) 232-4049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000457 NY Practitioner - Physician Assistant 1759396138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vantage Medical Associates PCGroup PAC ID 0547673816, 84 clinicians

Practice addresses (Care Compare)

1612 Central Ave
Suite 201
Far Rockaway, NY 11691-4002
Phone (516) 792-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00046000NJMDPhysician Assistant
18701CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Medical Associates PC CurrentSince Oct 3, 2025 Accepting new patients
Adirondack Medical Center CurrentSince Apr 13, 2009 Accepting new patients
Emergency Physician Services of New York, P.C. Physician Assistant CurrentSince Jul 15, 2011 Accepting new patients
Adirondack Medical Center CurrentSince Apr 13, 2009 Accepting new patients

Locations

1612 Central Ave
Ste 201
Far Rockaway, NY 11691
Phone (516) 792-1600

1612 Central Ave
Far Rockaway, NY 11691
Phone (718) 223-5820

29 Church St
Lake Placid, NY 12946
Phone (518) 523-1122

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

7 Stetson Rd
Tupper Lake, NY 12986
Phone (518) 359-7000

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1154414100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 PORT ROYALE DR S APT 101",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087933",
            "telephone_number": "201-232-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 CENTRAL AVE STE 201",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914002",
            "telephone_number": "718-831-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "DELINA",
        "middle_name": "LILA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.