Wendy Fader, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0004599 Issued in FL

Practice address

5295 Town Center Rd
#401
Boca Raton, FL 33486

Phone

(561) 362-5530

Fax

(561) 362-5595

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• David B. Miller, Psy.D., P.a.

  • Specialist
  • Boca Raton, FL
  • NPI 1063695278
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1245284603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5295 TOWN CENTER RD",
            "address_2": "#401",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33486",
            "telephone_number": "561-362-5530",
            "fax_number": "561-362-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 TOWN CENTER RD",
            "address_2": "#401",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33486",
            "telephone_number": "561-362-5530",
            "fax_number": "561-362-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADER",
        "first_name": "WENDY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY0004599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "73916",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ezr Research (Espinosa Neuroscience Institute)
• F.I.T. PT, LLC
• Arianna Fabiani
• Angela Fabiano, OD
• Adrian J Fabrikant, L.M.H.C
• Steven Fagien, M.D.
• Fagva LLC
• Samer A Fahmy, M.D
• Darnell Fair
• Derwin Gerod Fair Jr.

• Psychologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.