Active NPI
Jeremy Fam
- Anesthesiology Physician
- Galveston, TX
National Provider Identifier
1346930229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- BP10084377
- Practice address
- 301 University Blvd
Galveston, TX 77555-5302 - Phone
- (409) 266-7856
- NPI assigned
- May 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | BP10084377 | TX | Primary |
Addresses
Primary practice location
301 University Blvd
Galveston, TX 77555-5302
Mailing address
PO Box 650859
Dallas, TX 75265-0859
Phone (409) 772-2222
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230614002095 | TX | Order and Referring Only - Anesthesiology | 9537527189 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1346930229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 650859",
"city": "DALLAS",
"state": "TX",
"postal_code": "752650859",
"telephone_number": "409-772-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 UNIVERSITY BLVD",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775555302",
"telephone_number": "409-266-7856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAM",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "BP10084377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.