Daniel Adrian Fajardo, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

062687 Issued in GA

Practice address

3011 Hampton Ave
Brunswick, GA 31520-4264

Phone

(912) 261-2669

Fax

(912) 261-0561

NPI assigned

Jun 9, 2007

Last updated

Aug 19, 2009By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, 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

Specialty

Pathology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital District Pathology Associates PLLCGroup PAC ID 4486078987, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406

Merit-based Incentive Payment System (MIPS)

Final score

88.33 of 100Reported as group

Quality

76.67

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Capital District Pathology Associates PLLC

  • Clinical Pathology Physician
  • Albany, NY
  • NPI 1720602493
  Medicare reassignment Care Compare group NPD
• Southeastern Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Brunswick, GA
  • NPI 1821104704
  Medicare reassignment NPD
• Southeastern Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Brunswick, GA
  • NPI 1992963268
  NPD
• Coastal Care Inc

  • Primary Care Clinic/Center
  • Waycross, GA
  • NPI 1538367149
  NPD (past)
• Southeastern Pathology Associate

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1558577346
  NPD (past)

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

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation
• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• Sunnyview Hospital and Rehabilitation Center

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1578664470
  Care Compare affiliation

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1346443959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 HAMPTON AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204264",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 HAMPTON AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204264",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "DANIEL",
        "middle_name": "ADRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "062687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP2-0021332",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Excelarate Physical Therapy
• Expand Health, LLC
• Jennifer Faillace, CRNA
• Amy Hamm Faircloth, P.T.
• Seyreen Faisal, M.D.
• Family Chiropractic Care Inc.
• Family Dental of Brunswick LLC
• Family Health Chiropractic
• Family Home Medical Equipment, LLC (Total Respiratory)
• Family Medicine Professionals Inc

• Anatomic Pathology & Clinical Pathology Physician in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.