NPIMap

Organization Active NPI

George E. Fava MD PC

Doing business as Fava & Maria Eye Associates

  • Ophthalmology Physician
  • Lebanon, PA
National Provider Identifier
1245291848
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GEORGE E. FAVA MD PC
Doing business as
Fava & Maria Eye Associates
Practice address
875 Norman Dr
Lebanon, PA 17042-7454
Phone
(717) 272-2010
Fax
(717) 272-2937
NPI assigned
Mar 31, 2006
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Dr. Mark C Maria, MDNPI 1154325504
Title
President & Ceo
Phone
(717) 821-1481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

875 Norman Dr
Lebanon, PA 17042-7454

Mailing address

875 Norman Dr
Lebanon, PA 17042-7454
Phone (717) 272-2010

Other names 1

  • Fava & Maria Eye Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040623000749 PA Part B Supplier - Clinic/Group Practice 7517942428 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Lebanon, PA
O20100930040042 PA DME Supplier - Physician - OphthalmologyDME Supplier - Optician 7517942428 Practice locations: Lebanon, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Fava Maria Eye Associ2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1245291848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427454",
            "telephone_number": "717-272-2010",
            "fax_number": "717-272-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427454",
            "telephone_number": "717-272-2010",
            "fax_number": "717-272-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE E. FAVA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "MARIA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "717-821-1481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fava & Maria Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fava & Maria Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.