Fazeel Javaid, MD – Internal Medicine Physician

Key facts

NPI: 1194394684
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 83832-20 (WI)
Practice address: Dep of Internal Medicine Lincoln Medical
Center, Suite 8-20 234 E 149TH Street
Bronx, NY 10451
Phone: (718) 579-5874
NPI assigned: Jun 21, 2021
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Apogee Medical Group, Wisconsin, S.C Internal Medicine Physician · Scottsdale, AZ · NPI 1629415591

Medicare reassignment Care Compare group NPD INTERNAL MEDICINE · WI

Hospital & facility affiliations 1

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

Bellin Memorial Hospital Inc. General Acute Care Hospital · Green Bay, WI · NPI 1891740585

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Internal Medicine
Education: Other, 2015
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Apogee Medical Group Wisconsin SC (42 clinicians)

Practice addresses (Care Compare)

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500

Hospital & facility affiliations

Bellin Memorial Hospital Hospital · Green Bay, WI · CCN 520049

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240517000580	WI	Practitioner - Internal Medicine	0749621019	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
83832-20	WI	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Apogee Medical Group, Wisconsin, S.C	Internal Medicine	Current since May 1, 2024	Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Interoperability endpoints

Direct secure messaging: fjavaid1024363@direct.emplifyhealth.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Internal Medicine Physician	207R00000X	83832-20	WI	Yes

Addresses

Primary practice location

Dep of Internal Medicine Lincoln Medical
Center, Suite 8-20 234 E 149TH Street
Bronx, NY 10451

Mailing address

54-X, Housing Colony
College Road
Layyah, PUNJAB 31200
PK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 1, 2024.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1194394684",
    "addresses": [
        {
            "country_code": "PK",
            "country_name": "Pakistan",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "54-X, HOUSING COLONY",
            "address_2": "COLLEGE ROAD",
            "city": "LAYYAH",
            "state": "PUNJAB",
            "postal_code": "31200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEP OF INTERNAL MEDICINE LINCOLN MEDICAL",
            "address_2": "CENTER, SUITE 8-20 234 E 149TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "718-579-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVAID",
        "first_name": "FAZEEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "83832-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

All providers in Bronx, NY · Internal Medicine Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.