Individual provider Active NPI

Fabiano Lima Das Gracas

  • Pulmonary Disease Physician
  • Richmond Hill, NY
National Provider Identifier
1538659644
Registry record updated May 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME161553 Issued in FL
Practice address
8900 Van Wyck Expy
Richmond Hill, NY 11418-2832
Phone
(904) 422-8717
NPI assigned
May 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X ME161553 FL Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Richmond Hill, NY 11418-2832

Mailing address

8900 Van Wyck Expy
Richmond Hill, NY 11418-2832
Phone (904) 422-8717

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230803003065 FL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 5193060408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aldor-Pulmonary, LLCGroup PAC ID 9335431816, 4 clinicians

Practice addresses (Care Compare)

602 S Audubon Ave
Suite B
Tampa, FL 33609-4217
Phone (813) 853-0500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161553FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aldor-Pulmonary, LLC Pulmonary Disease CurrentSince Aug 1, 2023 Accepting new patients

Locations

1901 Haverford Ave
Sun City Ctr, FL 33573
Phone (813) 422-5533

602 S Audubon Ave
Ste C
Tampa, FL 33609
Phone (813) 817-5073

602 S Audubon Ave
Ste B
Tampa, FL 33609
Phone (813) 348-4885

Interoperability endpoints

  • Direct secure messaging: fdasgracas80817@direct.medisys.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/EFDHAD

Organizations & group practices 1

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 3

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685145600000",
    "number": "1538659644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "904-422-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "904-422-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS GRACAS",
        "first_name": "FABIANO",
        "middle_name": "LIMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME161553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.