Emelynn Joanne Fajardo, D.O.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

C2-0013079 Issued in DE

Practice address

1600 Rockland Rd
Wilmington, DE 19803-3607

Phone

(302) 651-4200

Fax

(302) 651-5951

NPI assigned

Jun 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efajardo77079@direct.nemours.org

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.

• Nemours New Jersey Physician Practice, P.C.

  • Pediatrics Physician
  • Deptford, NJ
  • NPI 1265874713
  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1457615460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "026-514-0003",
            "fax_number": "302-651-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "EMELYNN",
        "middle_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "DE",
            "license": "C2-0013079",
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NJ",
            "license": "25MB09117500",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "PA",
            "license": "OS019939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather C Fackelman
• William Fader, FNP
• Lynn M Fahey
• Fairfax Medical P.a.
• Debra Faith, RN
• Olalekan David Falade, PHARM.D
• Nicole Falasco, DPT
• Stephen J. Falchek, MD
• Valerie Joyce Falcioni, P.T.A.
• Falcon Therapy and Fitness LLC

• Pediatric Sports Medicine Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Pediatric Sports Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.