Philip Thomas Farabaugh, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C55939 Issued in CA

Practice address

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172

Phone

(909) 864-1097

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Uniformed Services Uhs Fe Hebert School of Med, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside-San Bernardino County Indian Health IncGroup PAC ID 4789867805, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: philip.farabaugh.p1@direct.rsbcihi.nextgenshare.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.

• Riverside-San Bernardino County Indian Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Terrace, CA
  • NPI 1174676670

  TX

  Medicare reassignment Care Compare group NPD
• Riverside-San Bernardino County Indian Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Mountain Center, CA
  • NPI 1366028086
  NPD
• Riverside-San Bernardino County Indian Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Terrace, CA
  • NPI 1720178478
  NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1285763615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARABAUGH",
        "first_name": "PHILIP",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C55939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emeritus Corporation
• Trisha N Engel
• Equanimity Hospice & Palliative Care, Inc.
• Eric Eschweiler, DNP, RN, FNP-C
• Marisol Espinoza Garcia, ACSW 123201
• Edna Karina Favela, R.D., CDE
• Ramon U. Ferra, MD
• Fit Forever Physical Therapy, Inc.
• Five Oaks Speech Therapy Services PC
• Ashley Fonseca-Tweed, FNP-BC

• Family Medicine Physician in Grand Terrace, CA
• Providers in Grand Terrace, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.