Individual provider Active NPI

Farnaz Jafari, MD

  • Family Medicine Physician
  • Kingston, NY
National Provider Identifier
1386138063
Registry record updated Sep 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A176694 Issued in CA
Practice address
1 Family Practice Dr
Kingston, NY 12401-6449
Phone
(845) 338-6400
Fax
(845) 339-7288
NPI assigned
Jun 18, 2018
Last updated
Sep 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A176694 CA Primary

Addresses

Primary practice location

1 Family Practice Dr
Kingston, NY 12401-6449

Mailing address

396 Broadway
Kingston, NY 12401-4626
Phone (845) 802-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231115002390 CA Practitioner - Family Practice 2466809280 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176694CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC CurrentSince Oct 3, 2023 Accepting new patients

Locations

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693612800000",
    "number": "1386138063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 BROADWAY",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014626",
            "telephone_number": "845-802-7600",
            "fax_number": "845-338-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FAMILY PRACTICE DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016449",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFARI",
        "first_name": "FARNAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2023-09-02",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A176694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.