David Fan, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

307971 Issued in NY

Practice address

1650 Grand Concourse
Bronx, NY 10457-7679

Phone

(718) 992-7669

NPI assigned

Jun 8, 2015

Last updated

Feb 13, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

General Surgery

Education

New York College of Osteo Medicine of New York Institute of Technology, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment Care Compare group NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bronxcare Health System

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1417027558
  Care Compare affiliation

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1467832113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577679",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "307971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Practice Dentistry (Family Practice Dentistry & Laser Dental Care LLC)
• Family Support Systems Unlimited, Inc.
• Family Wellness Program, LLC
• Kim Famous, PA
• Albert Dennis Famularo, LMSW
• Rung Tan Fan, M.D.
• Xuanjia Fan, MD
• Yu Mei Wu Fan, MD
• Fancy Pharmacy Inc
• Lauren Fane

• Surgery Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.