NPIMap

Individual provider Active NPI

Jason Faller, M.D.

  • Specialist
  • New York, NY
National Provider Identifier
1558352740
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
151022 Issued in NY
Practice address
333 W 57TH St
Suite 104
New York, NY 10019-3159
Phone
(212) 307-6880
Fax
(212) 247-6318
NPI assigned
Nov 4, 2005
Last updated
Jul 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 151022 NY Primary

Addresses

Primary practice location

333 W 57TH St
Suite 104
New York, NY 10019-3159

Mailing address

333 W 57TH St
Suite 104
New York, NY 10019-3159
Phone (212) 307-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051012001073 NY Practitioner - RheumatologyPractitioner - Internal Medicine 3072538669 Reassigns benefits to 2 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

2 Crosfield Ave
Suite 315
West Nyack, NY 10994-2220
Phone (845) 735-4114

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151022NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Nyack Hospital CurrentSince Dec 22, 2021 Accepting new patients
Montefiore Nyack Hospital CurrentSince Dec 22, 2021 Accepting new patients
White Plains Medical Diagnostic Services, PC CurrentSince Oct 1, 2022 Accepting new patients
St Lukes Roosevelt Community Care Past Accepting new patients

Locations

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

97 Route 303
Tappan, NY 10983
Phone (845) 348-2198

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

2 Crosfield Ave
Ste 315
West Nyack, NY 10994
Phone (845) 680-0800

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jasonfaller@jfmd.allscriptsdirect.net
  • Direct secure messaging: jfaller68804@northwell.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1558352740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 57TH ST",
            "address_2": "SUITE 104",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193159",
            "telephone_number": "212-307-6880",
            "fax_number": "212-247-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 57TH ST",
            "address_2": "SUITE 104",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193159",
            "telephone_number": "212-307-6880",
            "fax_number": "212-247-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "151022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.