Individual provider Active NPI

Evelyn Fabian, FNP-BC

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1558738484
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339929 Issued in NY
Practice address
71 Carroll St
Brooklyn, NY 11231-2767
Phone
(347) 479-1110
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339929 NY Primary

Addresses

Primary practice location

71 Carroll St
Brooklyn, NY 11231-2767

Mailing address

71 Carroll St
Brooklyn, NY 11231-2767
Phone (347) 479-1110

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220001658 NY Practitioner - Nurse Practitioner 9335420918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RJ Medical and Urgent Care PLLCGroup PAC ID 0547567828, 5 clinicians

Practice addresses (Care Compare)

464 Bay Ridge Ave
Suite a
Brooklyn, NY 11220-5906
Phone (718) 680-6006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
339929NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 7, 2017 Accepting new patients
New York University CurrentSince Oct 7, 2017 Accepting new patients
RJ Medical & Urgent Care, PLLC CurrentSince Nov 1, 2016 Accepting new patients

Locations

464 Bay Ridge Ave
Ste A
Brooklyn, NY 11220
Phone (718) 680-6006

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1798/brand/1/csg/1/fhir/r4

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": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1558738484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CARROLL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312767",
            "telephone_number": "347-479-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CARROLL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312767",
            "telephone_number": "347-479-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "EVELYN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.