Active NPI
Cynthia Ann Fazekas, RNP
- Nurse Practitioner
- Monterey, CA
National Provider Identifier
1275639247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NPF5769
- Practice address
- 977 Pacific St Ste B
Monterey, CA 93940-4400 - Phone
- (831) 648-8000
- Fax
- (831) 648-7799
- NPI assigned
- Sep 16, 2006
- Last updated
- Nov 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NPF5769 | CA | Primary |
Addresses
Primary practice location
977 Pacific St Ste B
Monterey, CA 93940-4400
Mailing address
977 Pacific St Ste B
Monterey, CA 93940-4400
Phone (831) 648-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00799099 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NPF5769 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spirit Lake Health Center | Past | Accepting new patients | |
| Spirit Lake Tribe | Past | Accepting new patients | |
| California Skin Institute, a Medical Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dermatology Physician
- Mountain View, CA
- NPI 1154527901
-
- Health Service Clinic/Center
- Fort Totten, ND
- NPI 1073665493
-
dba Spirit Lake Health Center
- Health Service Clinic/Center
- Fort Totten, ND
- NPI 1114472891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1275639247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "977 PACIFIC ST STE B",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939404400",
"telephone_number": "831-648-8000",
"fax_number": "831-648-7799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "977 PACIFIC ST STE B",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939404400",
"telephone_number": "831-648-8000",
"fax_number": "831-648-7799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZEKAS",
"first_name": "CYNTHIA",
"middle_name": "ANN",
"credential": "RNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NPF5769",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00799099",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.