NPIMap

Organization Active NPI

Ellenville Emergency Medical Associates PLLC

  • Emergency Medicine Physician
  • Ellenville, NY
National Provider Identifier
1477945905
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ELLENVILLE EMERGENCY MEDICAL ASSOCIATES PLLC
Practice address
10 Healthy Way
Ellenville, NY 12428-5612
Phone
(469) 401-2386
NPI assigned
Feb 20, 2015
Last updated
Apr 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Fareed Nabiel Fareed, MD
Title
Authorized Official
Phone
(917) 854-8007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

10 Healthy Way
Ellenville, NY 12428-5612

Mailing address

PO Box 781165
Philadelphia, PA 19178-1165
Phone (954) 939-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150508001689 NY Part B Supplier - Clinic/Group Practice 9436478658 Receives reassigned benefits from 22 practitioners
Practice locations: Ellenville, NY

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1477945905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781165",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191781165",
            "telephone_number": "954-939-5000",
            "fax_number": "877-250-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HEALTHY WAY",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124285612",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLENVILLE EMERGENCY MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "FAREED",
        "authorized_official_first_name": "FAREED",
        "authorized_official_middle_name": "NABIEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "917-854-8007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.