NPIMap

Individual provider Active NPI

Nick Gerald Faraci, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1235104662
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
159197 Issued in NY
Practice address
1407 W 6TH St
Brooklyn, NY 11204-4802
Phone
(718) 256-1052
Fax
(718) 256-4912
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 159197 NY Primary

Addresses

Primary practice location

1407 W 6TH St
Brooklyn, NY 11204-4802

Mailing address

4982 Hylan Blvd
Staten Island, NY 10312-6399
Phone (718) 967-6200

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
159197NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Staten Island University Hospital Past Accepting new patients
Comprehensive Pediatrics PC Pediatrics Past Accepting new patients
Richmond Medical Center Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: nfaraci@1670.securemail.mdnavigatorclinical.com
  • Direct secure messaging: nfaraci67768@northwell.direct-ci.com
  • Direct secure messaging: nfaraci130499@nyumc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: nif9051@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1235104662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4982 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126399",
            "telephone_number": "718-967-6200",
            "fax_number": "718-967-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044802",
            "telephone_number": "718-256-1052",
            "fax_number": "718-256-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARACI",
        "first_name": "NICK",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "159197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.