Dara Blum Facciani, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00403400 Issued in NJ

Practice address

741 Northfield Ave
West Orange, NJ 07052-1174

Phone

(973) 736-9980

NPI assigned

Apr 4, 2007

Last updated

Jul 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
• Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dara.facciani.1@2983.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Physician Assistant

  NPD (past)

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

• Kessler Institute for Rehabilitation Inc

  dba Kessler Rehabilitation Center

  • Rehabilitation Hospital
  • West Orange, NJ
  • NPI 1013919620

  Inpatient rehabilitation facility

  Care Compare affiliation
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1245352707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "973-736-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521174",
            "telephone_number": "973-736-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACCIANI",
        "first_name": "DARA",
        "middle_name": "BLUM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00403400",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00109600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exelixis ABA Therapy and Behavior Consulting LLC
• Expressive Minds Therapy LLC
• Eyecare 20/20- West Orange PA
• Richard Wayne Eytel, DMD
• Adaku Ezeadi
• Christine Faccone, LPC
• Sydney Fackrell, PT, DPT
• Adila Asim Fakhar, RD
• Evie L Falda
• Herbert Faleck, D.O.

• Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.