Sam Fayman, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036090128 Issued in IL

Practice address

201 N Prairie St
Galesburg, IL 61401-4617

Phone

(309) 344-7546

Fax

(309) 342-9946

NPI assigned

Sep 1, 2006

Last updated

Aug 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1235231234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N PRAIRIE ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614014617",
            "telephone_number": "309-344-7546",
            "fax_number": "309-342-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N PRAIRIE ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614014617",
            "telephone_number": "309-344-7546",
            "fax_number": "309-342-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYMAN",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036090128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L Engebretson, M.S, LCPC
• Jeff Engwall, RPH
• Neda Esfahani
• Elizabeth Eyler, O.D.
• Family Planning Service of Western Il, Inc.
• Ashley Marie Felt
• First Choice Medical Equipment, Inc. (AeroCare)
• Donald R Fisk, M.D.
• Jane L Fitch, LCSW
• Richard Flacco

• Dermatology Physician in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.