Jerry Dean Fain, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

H4310 Issued in TX

Practice address

901 W 38TH St
Suite 200
Austin, TX 78705-1165

Phone

(512) 419-9733

Fax

(512) 451-3709

NPI assigned

Jun 14, 2006

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jerry.fain.1@28513.direct.athenahealth.com

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1447293840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 38TH ST",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051165",
            "telephone_number": "512-419-9733",
            "fax_number": "512-451-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "JERRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "H4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "8BP225",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00645999",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131313207",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131313202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "830004599",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131313208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy Scott Fagin, MD
• Jennifer A Fahrenbacher, LCSW
• Kathleen Fahrner, PH.D.
• Niamh Fahy, MT-BC
• Becky Ann Fain, M.D.
• Fainor Online Outlet LLC
• Daria Fainshtein, PT
• Susan Fairbanks, LCSW
• Jamie Lew Fairchild, D.M.D.
• Ashley S Fairleigh, MS CCC SLP

• Hematology & Oncology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Hematology & Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.