Fayegh Jadali, MD PHD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9700604 Issued in NC

Practice address

2961 Crouse Lane Ste a
Burlington, NC 27215

Phone

(336) 586-9799

Fax

(336) 589-9760

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

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.

• Alamance Internal and Nuclear Medicine

  • Endocrinology, Diabetes & Metabolism Physician
  • Burlington, NC
  • NPI 1538401161
  Medicare reassignment NPD Authorized official
• Trillium Clinic

  • Dermatology Physician
  • Chapel Hill, NC
  • NPI 1093419566
  NPD
• Rmsa Inc Health Center

  • Geriatric Medicine (Family Medicine) Physician
  • Reidsville, NC
  • NPI 1679525380
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1427144104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 CROUSE LANE STE A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-586-9799",
            "fax_number": "336-589-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 CROUSE LANE STE A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-586-9799",
            "fax_number": "336-589-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADALI",
        "first_name": "FAYEGH",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9700604",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "9700604",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891042X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1042X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0403383",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arin L Isenstein, M.D.
• Gillian Izlar
• J Madison Clark MD PLLC
• Stephen Daniel Jackson, MD
• Jacqueline Sonceau PLLC
• Kimberly Lauren Jakubowski, DPT
• Jeneba Jalloh, NP
• James G Rafael
• Ar'Mallorie James
• Laura A James, PA-C

• Internal Medicine Physician in Burlington, NC
• Providers in Burlington, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.