Organization Active NPI

Tania Faruque M.D. P.C.

  • Pain Medicine Physician
  • Escondido, CA
National Provider Identifier
1376140152
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
TANIA FARUQUE M.D. P.C.
Practice address
255 N Elm St Ste 101
Escondido, CA 92025-3431
Phone
(760) 489-1876
Fax
(760) 489-1748
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Dr. Tania Faruque, MDNPI 1881910511
Title
Owner
Phone
(734) 945-7544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

255 N Elm St Ste 101
Escondido, CA 92025-3431

Mailing address

255 N Elm St Ste 101
Escondido, CA 92025-3431
Phone (604) 891-8767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201110002563 CA Part B Supplier - Clinic/Group Practice 9830509405 Receives reassigned benefits from 1 practitioner
Practice locations: Escondido, CA
O20210208001190 CA DME Supplier - Physician - Anesthesiology 9830509405 Practice locations: Escondido, CA

National Provider Directory

National Provider Directory

Locations

255 N Elm St
Ste 101
Escondido, CA 92025
Phone (760) 489-1876

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1376140152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N ELM ST STE 101",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253431",
            "telephone_number": "604-891-8767",
            "fax_number": "760-489-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N ELM ST STE 101",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253431",
            "telephone_number": "760-489-1876",
            "fax_number": "760-489-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANIA FARUQUE M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "FARUQUE",
        "authorized_official_first_name": "TANIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-945-7544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.