Individual provider Active NPI

Matthew John Faber, PA-C

  • Surgical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1407158504
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA053645 Issued in PA
Practice address
333 Cottman Avenue
Fox Chase Cancer Center
Philadelphia, PA 19111
Phone
(215) 728-6900
Fax
(215) 728-2773
NPI assigned
Nov 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA053645 PA Primary

Addresses

Primary practice location

333 Cottman Avenue
Fox Chase Cancer Center
Philadelphia, PA 19111

Mailing address

333 Cottman Avenue
Medical Staff Office/Enrollment
Philadelphia, PA 19111
Phone (215) 728-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170810000209 CT Practitioner - Physician Assistant 4789861659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Anesthesia Associates LLCGroup PAC ID 1759281165, 402 clinicians

Practice addresses (Care Compare)

80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA053645PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mfaber@xdr.hhchealthdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1407158504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVENUE",
            "address_2": "MEDICAL STAFF OFFICE/ENROLLMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-6900",
            "fax_number": "215-728-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVENUE",
            "address_2": "FOX CHASE CANCER CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-6900",
            "fax_number": "215-728-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABER",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA053645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.