Pavel Fadeev, PSY.D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

018621 Issued in NY

Practice address

585 Schenectady Ave
Brooklyn, NY 11203-1891

Phone

(718) 604-5928

Fax

(718) 604-5699

NPI assigned

Aug 26, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Interfaith Professional Physician Services, P.C.

  • Allergy Physician
  • Brooklyn, NY
  • NPI 1457643991
  Medicare reassignment NPD
• Kingsbrook Medical Associates, PC

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1104112838
  Medicare reassignment
• Clinical Psychassociates LLP

  • Clinical Psychologist
  • New York, NY
  • NPI 1124051925
  NPD (past)

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1598998411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WEST END AVE",
            "address_2": "SUITE 2-C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "347-461-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031891",
            "telephone_number": "718-604-5928",
            "fax_number": "718-604-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEEV",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "018621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Funmilola Fadipe

• Clinical Neuropsychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.