NPIMap

Individual provider Active NPI

Pouneh Khadejeh Fazeli, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Pittsburgh, PA
National Provider Identifier
1497732887
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD468466 Issued in PA
Practice address
3601 5TH Ave
Suite 3B
Pittsburgh, PA 15213-3403
Phone
(412) 586-9700
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 230492 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 227372 MA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD468466 PA Primary

Addresses

Primary practice location

3601 5TH Ave
Suite 3B
Pittsburgh, PA 15213-3403

Mailing address

200 Lothrop Street
BST W1061
Pittsburgh, PA 15213
Phone (412) 586-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003001832 PA Practitioner - EndocrinologyPractitioner - Internal Medicine 2769412717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

200 Lothrop St
Pittsburgh, PA 15213-2536

3601 5TH Ave
Pittsburgh, PA 15213-3403

Hospital & facility affiliations

  • Upmc Presbyterian Shadyside Hospital, Pittsburgh, PA, CCN 390164
  • Upmc Altoona Hospital, Altoona, PA, CCN 390073
  • Upmc Passavant Hospital, Pittsburgh, PA, CCN 390107
  • Upmc East Hospital, Monroeville, PA, CCN 390328

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
230492NYMDInternal Medicine Physician
MD468466PAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Endocrinology, Diabetes & Metabolism CurrentSince Sep 1, 2019 Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 1, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Upmc Emergency Medicine Inc Past Accepting new patients

Locations

3601 5th Ave
Pittsburgh, PA 15213
Phone (412) 383-8700

200 Lothrop St
#W1061
Pittsburgh, PA 15213

3601 5th Ave
Ste 3B
Pittsburgh, PA 15213
Phone (412) 586-9700

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

Interoperability endpoints

  • Direct secure messaging: pouneh.k.fazeli@upmcdirect.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1497732887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LOTHROP STREET",
            "address_2": "BST W1061",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "412-586-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 5TH AVE",
            "address_2": "SUITE 3B",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133403",
            "telephone_number": "412-586-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZELI",
        "first_name": "POUNEH",
        "middle_name": "KHADEJEH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "230492",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "227372",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD468466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.