Individual provider Active NPI

Paul Jeffrey Fine, MD

  • Surgery Physician
  • Bronx, NY
National Provider Identifier
1265053011
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0116040224 Issued in VA
Practice address
234 E 149TH St Ste 5-337
Bronx, NY 10451-5504
Phone
(718) 579-5725
NPI assigned
May 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 0116040224 VA Primary

Addresses

Primary practice location

234 E 149TH St Ste 5-337
Bronx, NY 10451-5504

Mailing address

234 E 149TH St Ste 5-337
Bronx, NY 10451-5504
Phone (718) 579-5725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20250718003524 VA Order and Referring Only - General SurgeryPractitioner - General Surgery 7214443035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0116040224VAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1265053011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST STE 5-337",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST STE 5-337",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "PAUL",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-04",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0116040224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.