Individual provider Active NPI

Avia J Facey, NP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1205504420
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F309997-01 Issued in NY
Practice address
1030 E 96TH St
Brooklyn, NY 11236-2335
Phone
(917) 306-4233
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309997-01 NY Primary

Addresses

Primary practice location

1030 E 96TH St
Brooklyn, NY 11236-2335

Mailing address

1030 E 96TH St
Brooklyn, NY 11236-2335
Phone (917) 306-4233

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
I20240401002152 NY Order and Referring Only - Nurse Practitioner 8224476965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F309997-01NYMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: afacey124464@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1205504420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E 96TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362335",
            "telephone_number": "917-306-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E 96TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362335",
            "telephone_number": "917-306-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACEY",
        "first_name": "AVIA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309997-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.