Fairyal Kassam, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60491262 Issued in WA

Practice address

201 E 65TH St
New York, NY 10065-6701

Phone

(212) 847-4700

NPI assigned

Jul 14, 2011

Sex

Female

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 WA

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

State licenses

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.

• Care Talk Health FL PA

  • Public Health & General Preventive Medicine Physician
  • Bethesda, MD
  • NPI 1477263077

  WA

  Medicare reassignment NPD
• Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Port Orchard, WA
  • NPI 1205886934

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1477841237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14516 99TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980117274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656701",
            "telephone_number": "212-847-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAM",
        "first_name": "FAIRYAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60491262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Kass, LCSW, MA
• William S Kass, MD
• Rebecca Kassabian
• Rena Kassak
• Jordan S Kassalow, OD
• Nisha Kassam
• Serena Kassam
• Zain Kassam
• Sorayya Kassamali Rickicki, LM, CM, IBCLC
• Lee D. Kassan, M.A.

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.