Fady Michael

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME142712 Issued in FL

Practice address

1580 Santa Barbara Blvd
The Villages, FL 32159-6827

Phone

(352) 259-2159

Fax

(352) 259-5731

NPI assigned

Apr 17, 2017

Last updated

Jan 6, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1497289433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-388-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SANTA BARBARA BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596827",
            "telephone_number": "352-259-2159",
            "fax_number": "352-259-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "FADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME142712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Merkiel
• James H Mersey, M.D.
• Caroline F Merveille, M.D.
• Kathleen A Meyer, MD
• Michael Glick, M.D. P.a.
• Alyssa Michalowski, DPT
• Michelle M Zielecki PA
• Mid Florida Eye Center, PA
• Manuel R Middleton, D.D.S.
• Eric Richard Mielke

• Internal Medicine Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.