Individual provider Active NPI

Jayson Nuwon Fernando, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1326836750
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60-P134336-01 Issued in NY
Practice address
155 Dean St
Brooklyn, NY 11217-2213
Phone
(718) 694-6700
NPI assigned
Apr 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60-P134336-01 NY Primary

Addresses

Primary practice location

155 Dean St
Brooklyn, NY 11217-2213

Mailing address

280 Prospect Ave Apt 1F
Hackensack, NJ 07601-2537
Phone (908) 868-0190

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623000351 NY Practitioner - Internal Medicine 6305358771 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60-P134336-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Solutions P.C. Internal Medicine CurrentSince Mar 28, 2025 Accepting new patients

Locations

155 Dean St
Brooklyn, NY 11217
Phone (718) 694-6700

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

275 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946

154 Prospect Ave
Plattsburgh, NY 12901
Phone (518) 563-5440

Organizations & group practices 1

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": "1745625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1326836750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 PROSPECT AVE APT 1F",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012537",
            "telephone_number": "908-868-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 DEAN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172213",
            "telephone_number": "718-694-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "JAYSON",
        "middle_name": "NUWON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-26",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "60-P134336-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.