Active NPI
Faouzi Hage, PA-C
- Physician Assistant
- North Stonington, CT
National Provider Identifier
1619096948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 467
- Practice address
- 75 Swantown Hill Rd
North Stonington, CT 06359-1022 - Phone
- (860) 445-3005
- Fax
- (860) 535-3401
- NPI assigned
- Mar 28, 2007
- Last updated
- Feb 18, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 467 | CT | Primary |
Addresses
Primary practice location
75 Swantown Hill Rd
North Stonington, CT 06359-1022
Mailing address
22 Colony Rd
East Lyme, CT 06333-1315
Phone (860) 514-7339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 467 | CT | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Council on Alcoholism and Drug Dependence Inc | Current | Accepting new patients | |
| Stonington Behavioral Health Inc | Past | Accepting new patients |
Locations
37 Camp Moween Rd
Lebanon, CT 06249
Phone (860) 886-2495
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581984000000",
"number": "1619096948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 COLONY RD",
"city": "EAST LYME",
"state": "CT",
"postal_code": "063331315",
"telephone_number": "860-514-7339",
"fax_number": "860-535-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 SWANTOWN HILL RD",
"city": "NORTH STONINGTON",
"state": "CT",
"postal_code": "063591022",
"telephone_number": "860-445-3005",
"fax_number": "860-535-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGE",
"first_name": "FAOUZI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2020-02-18",
"certification_date": "2020-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Stonington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.