Individual provider Active NPI

Revital Faro, M.D.

  • Maternal & Fetal Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1275892812
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
25MA08995800 Issued in NJ
Practice address
125 Paterson St
Cab Second Floor
New Brunswick, NJ 08901-1962
Phone
(732) 235-6632
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 25MA08995800 NJ Primary

Addresses

Primary practice location

125 Paterson St
Cab Second Floor
New Brunswick, NJ 08901-1962

Mailing address

125 Paterson St
Cab Second Floor
New Brunswick, NJ 08901-1962
Phone (732) 235-6632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140515001067 NJ Practitioner - Obstetrics/Gynecology 8527281732 Reassigns benefits to 3 organizations
I20200806002828 NY Practitioner - Obstetrics/Gynecology 8527281732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
FL 1
Bronx, NY 10457-7606
Phone (718) 992-7669

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Current Accepting new patients
Bronxcare Health System CurrentSince Mar 18, 2020 Accepting new patients
Saint Peter's University Hospital CurrentSince Feb 24, 2014 Accepting new patients
Bronxcare Health System CurrentSince Mar 18, 2020 Accepting new patients
Saint Peter's Specialty Physicians, P.C. Maternal & Fetal Medicine CurrentSince Feb 15, 2020 Accepting new patients
Saint Peter's University Hospital CurrentSince Feb 24, 2014 Accepting new patients
Saint Peter's Healthcare System Physician Associates CurrentSince Jul 1, 2016 Accepting new patients

Locations

500 River Ave
Ste 110
Lakewood, NJ 08701
Phone (732) 339-7360

240 Easton Ave
Fl 3
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

125 Paterson St
Fl Second
New Brunswick, NJ 08901
Phone (732) 235-6632

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

1650 Grand Concourse
Fl 1
Bronx, NY 10457
Phone (718) 518-5340

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1275892812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "CAB SECOND FLOOR",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "CAB SECOND FLOOR",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARO",
        "first_name": "REVITAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA08995800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.