Enrico Fazzini, DO

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

157518 Issued in NY

Practice address

108-14 72ND Avenue
2ND Floor
Forest Hills, NY 11375

Phone

(718) 263-5600

NPI assigned

Jun 27, 2006

Last updated

Jan 25, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Neurology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Five Towns Total Medical Care, P.C.Group PAC ID 9133182678, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

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.

• Five Towns Total Medical Care, P.C.

  • Specialist
  • Lawrence, NY
  • NPI 1851319305
  Medicare reassignment Care Compare group
• Emerald City Medical PC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1295374965
  NPD Authorized official
• Enrico Fazzini, D.O., P.C

  • Neurology Physician
  • Forest Hills, NY
  • NPI 1326128034
  NPD (past) Authorized official
• Maimonides Cardiology FPP

  • Cardiovascular Disease Physician
  • Brooklyn, NY
  • NPI 1477803385
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1407883150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-14 72ND AVENUE",
            "address_2": "2ND FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108-14 72ND AVENUE",
            "address_2": "2ND FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZINI",
        "first_name": "ENRICO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "157518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN 133530704",
            "identifier": "TAX ID",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruben Fattakhov, DDS
• Nicholas Favia, L.AC.
• Michelle Faylayeva, MSED
• Jonathan Levi Fayzakov, DDS
• Natalya Fazilova
• Bonnie Federman, M.D., CGC
• Feet for Life Podiatry & Foot Surgery PLLC
• Andrea Feher, M.D.
• Arthur Jay Feigenbaum, DMD
• Esther Feigenbaum, LCSW

• Neurology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.