Individual provider Active NPI

Phillip N Fyman, MD

  • Interventional Pain Medicine Physician
  • Syosset, NY
National Provider Identifier
1528050051
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
131071 Issued in NY
Practice address
121 Eileen Way
Syosset, NY 11791-5302
Phone
(516) 496-4964
Fax
(516) 496-4951
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 131071 NY Primary

Addresses

Primary practice location

121 Eileen Way
Syosset, NY 11791-5302

Mailing address

121 Eileen Way
Syosset, NY 11791-5302
Phone (516) 496-4964

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050920001238 NY Practitioner - Interventional Pain Management 2769416650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131071NYMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip Fyman and Alexander Weingarten MD PC CurrentSince Oct 1, 2001 Accepting new patients
Phillip Fyman and Alexander Weingarten MD PC Interventional Pain Medicine CurrentSince Oct 1, 2001 Accepting new patients
CMC Radiological Services PC Past Accepting new patients

Locations

366 N Broadway
Ste 305
Jericho, NY 11753
Phone (516) 496-4964

125 S Service Rd
Jericho, NY 11753
Phone (516) 334-4646

2001 Marcus Ave
Ste S20
New Hyde Park, NY 11042
Phone (516) 358-4673

121 Eileen Way
Syosset, NY 11791
Phone (516) 496-4964

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1528050051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EILEEN WAY",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915302",
            "telephone_number": "516-496-4964",
            "fax_number": "516-496-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 EILEEN WAY",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915302",
            "telephone_number": "516-496-4964",
            "fax_number": "516-496-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYMAN",
        "first_name": "PHILLIP",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "131071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.