Richard Anthony Fazio, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

140259 Issued in NY

Practice address

78 Todt Hill Rd
Suite 203
Staten Island, NY 10314-4528

Phone

(718) 448-1122

Fax

(718) 448-8318

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: richardfazio@mai.allscriptsdirect.net
• Direct secure messaging: richard.fazio.1@19656.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 and National Provider Directory roles.

• Richard a. Fazio MD, P.C.

  • Gastroenterology Physician
  • Staten Island, NY
  • NPI 1447303128
  NPD Authorized official
• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1285601419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD",
            "address_2": "SUITE 203",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD",
            "address_2": "SUITE 203",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-448-1122",
            "fax_number": "718-448-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "140259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00767666",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0023395",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amna Fazal, PHARMD
• Raffat Fazal
• Brianna Noelle Fazio, M.S. CCC-SLP, TSSLD
• Jennifer Marie Fazio, LPN
• Maria Catherine Fazio, BCBA
• Staci Ann Fazio, LPN
• FC Medical Inc
• Thomas Edward Fealey, M.D.
• Felix Fearns, PA
• Marie Feaser

• Gastroenterology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.