NPIMap

Organization Active NPI

Fayn Medical PC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1538198635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223026 Issued in NY
Legal business name
FAYN MEDICAL PC
Practice address
1517 Voorhies Ave
Ground Floor
Brooklyn, NY 11235-3970
Phone
(718) 676-4500
Fax
(718) 942-5649
NPI assigned
Jul 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Irina Klebanov, D.O.NPI 1013955285
Title
Owner
Phone
(718) 676-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 223026 NY Primary

Addresses

Primary practice location

1517 Voorhies Ave
Ground Floor
Brooklyn, NY 11235-3970

Mailing address

1517 Voorhies Ave
Ground Floor
Brooklyn, NY 11235-3970
Phone (718) 676-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080204000386 NY Part B Supplier - Clinic/Group Practice 8527140227 Receives reassigned benefits from 7 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1517 Voorhies Ave
Brooklyn, NY 11235
Phone (718) 368-1666

209 Avenue P
Ste 1A
Brooklyn, NY 11204
Phone (718) 676-4500

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538198635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 VOORHIES AVE",
            "address_2": "GROUND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353970",
            "telephone_number": "718-676-4500",
            "fax_number": "718-942-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 VOORHIES AVE",
            "address_2": "GROUND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353970",
            "telephone_number": "718-676-4500",
            "fax_number": "718-942-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEBANOV",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-676-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "223026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.