Gil V Fajardo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA62055 Issued in NJ

Practice address

333 60TH St
West New York, NJ 07093

Phone

(201) 453-8777

Fax

(201) 453-8804

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palisades Medical Center Hospital, North Bergen, NJ, CCN 310003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gil.fajardo@direct.hobokenumc.md

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.

• Bergenline Family Medicine

  • Primary Care Clinic/Center
  • West New York, NJ
  • NPI 1811207475
  Medicare reassignment NPD Authorized official
• Humc Opco LLC

  dba Hoboken University Hospital

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  dba Palisades Medical Center

  • General Acute Care Hospital
  • North Bergen, NJ
  • NPI 1730692344
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • North Bergen, NJ
  • NPI 1952028532

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336226463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 RAMBLING DRIVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "07076",
            "telephone_number": "201-453-8777",
            "fax_number": "201-453-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 60TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "07093",
            "telephone_number": "201-453-8777",
            "fax_number": "201-453-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "GIL",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA62055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Estrada, D.P.M.
• Fernando Ignacio Estrems, R.PH.
• Exceptional Home Care Training Institute LLC
• Eyes R US LLC
• Nicole Fairfax
• Family Practice Center, Corp.
• Armand P Fasano, M.D.
• David Fayngersh, M. D.
• Heidi Fentzke, D.C.
• Ninoska Fergusson, DMD

• Family Medicine Physician in West New York, NJ
• Providers in West New York, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.