Gregory Michael Fernandes, M.D.,

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA03967600 Issued in NJ

Practice address

St Marys Hospital
211 Pennington Ave
Passaic, NJ 07055

Phone

(973) 470-3095

Fax

(973) 470-3568

NPI assigned

Dec 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• St Marys Hospital

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1699748996
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417012337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HUFF RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702932",
            "telephone_number": "973-696-1140",
            "fax_number": "973-470-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST MARYS HOSPITAL",
            "address_2": "211 PENNINGTON AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "07055",
            "telephone_number": "973-470-3095",
            "fax_number": "973-470-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA03967600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galia Elke Feigenbaum, MS ED
• Deborah H Feinsod, LCSW
• Aviva Felder
• Rebecca Judith Feldman, LCSW
• Fenny I Pharmacy LLC (Fenny 1 Pharmacy)
• Anamary Fernandez, RN
• Gladys Santiago Fernandez, LCSW
• Yocasta Fernandez, MD
• Angel Ferrer, MD
• Simon Y Feuerman, PSYD, LCSW

• Anatomic Pathology & Clinical Pathology Physician in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.