Individual provider Active NPI

Daniel Fain

  • Physician Assistant
  • Patchogue, NY
National Provider Identifier
1275085367
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020313 Issued in NY
Practice address
101 Hospital Rd
Patchogue, NY 11772-4870
Phone
(631) 654-7100
NPI assigned
Oct 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020313 NY Primary
Surgical Physician Assistant 363AS0400X 020313 NY

Addresses

Primary practice location

101 Hospital Rd
Patchogue, NY 11772-4870

Mailing address

31 Paul CT
North Babylon, NY 11703-1122

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170310000036 NY Practitioner - Physician Assistant 0446534440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

3480 Veterans Memorial Hwy
Bohemia, NY 11716-1068
Phone (631) 289-0338

36 Lincoln Ave
Rockville Centre, NY 11570-5768
Phone (516) 536-2800

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Hospital & facility affiliations

  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020313NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC Physician Assistant CurrentSince Sep 18, 2019 Accepting new patients
True North Medical Group PC CurrentSince Sep 18, 2019 Accepting new patients
Emergency Medicine Physicians of Suffolk County, PLLC Past Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

3480 Veterans Memorial Hwy
Bohemia, NY 11716
Phone (631) 289-0338

775 Park Ave
Ste 380
Huntington, NY 11743
Phone (516) 914-6043

660 Broadway
Massapequa, NY 11758
Phone (516) 730-2222

1800 Walt Whitman Rd
Ste 120
Melville, NY 11747
Phone (631) 267-5130

1728 Sunrise Hwy
Merrick, NY 11566
Phone (516) 992-4568

635 Belle Terre Rd
Ste 204
Prt Jefferson, NY 11777
Phone (631) 474-0008

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

788 Harrison Ave
Riverhead, NY 11901
Phone (631) 591-3801

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

686 County Road 39A
Southampton, NY 11968
Phone (631) 283-0355

45 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 422-8080

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: danielfain@nslijmedgr.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1275085367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PAUL CT",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117031122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-654-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020313",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.