Individual provider Active NPI

Butros Awwad Saleh Fakhoury, MD

  • Internal Medicine Physician
  • Brighton, MA
National Provider Identifier
1447923602
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
289750 Issued in MA
Practice address
736 Cambridge St
Brighton, MA 02135-2907
Phone
(617) 789-3000
NPI assigned
Jul 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 289750 MA Primary
Internal Medicine Physician 207R00000X 0101280948 VA

Addresses

Primary practice location

736 Cambridge St
Brighton, MA 02135-2907

Mailing address

10 Camelot CT Apt 7B
Brighton, MA 02135-6114
Phone (347) 233-7423

Other practice location 1

1300 E Marshall St
Richmond, VA 23298-5028
Phone (804) 828-3144

Other practice location 2

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 380-0744

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address butros.fakhoury@steward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20240610002815 VA Practitioner - Internal Medicine 6800338500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 443-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
289750MAMDInternal Medicine Physician
0101280948VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Apr 29, 2024 Accepting new patients

Locations

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1300 E Marshall St
Richmond, VA 23298
Phone (804) 828-3144

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

Organizations & group practices 1

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1447923602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CAMELOT CT APT 7B",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021356114",
            "telephone_number": "347-233-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985028",
            "country_code": "US",
            "telephone_number": "804-828-3144",
            "fax_number": "804-628-7104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605000",
            "country_code": "US",
            "telephone_number": "804-380-0744",
            "fax_number": "804-443-6051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKHOURY",
        "first_name": "BUTROS",
        "middle_name": "AWWAD SALEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "289750",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101280948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "butros.fakhoury@steward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "736 Cambridge St",
            "city": "Brighton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021352907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.