Organization Active NPI

Fares Diarbakerli MD PC

  • Obstetrics & Gynecology Physician
  • Clifton, NJ
National Provider Identifier
1578832242
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA08580900 Issued in NJ
Legal business name
FARES DIARBAKERLI MD PC
Practice address
716 Broad St
Suite 2a
Clifton, NJ 07013-1645
Phone
(862) 571-6939
Fax
(973) 574-1008
NPI assigned
Dec 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Dr. Fares Diarbakerli, M.D.NPI 1508011602
Title
Owner
Phone
(862) 571-6939

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 25MA08580900 NJ Primary

Addresses

Primary practice location

716 Broad St
Suite 2a
Clifton, NJ 07013-1645

Mailing address

716 Broad St
Suite 2a
Clifton, NJ 07013-1645
Phone (862) 571-6939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141030000534 NJ Part B Supplier - Clinic/Group Practice 9335360692 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2040309Dr Fares Diarbakerli, MD716 Broad Street, Clifton, NJ 07013Provider-performed microscopyApr 26, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1578832242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "address_2": "SUITE 2A",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "862-571-6939",
            "fax_number": "973-574-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "address_2": "SUITE 2A",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "862-571-6939",
            "fax_number": "973-574-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARES DIARBAKERLI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "DIARBAKERLI",
        "authorized_official_first_name": "FARES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-571-6939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08580900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.