John R Fazio, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

191793 Issued in NY

Practice address

4900 Broad Rd
Pathology Dept
Syracuse, NY 13215-2265

Phone

(315) 492-5096

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pathology Associates of Syracuse, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
  • NPI 1629061791
  Medicare reassignment NPD
• Cytology Associates of Cny PLLC

  • Cytopathology Physician
  • Syracuse, NY
  • NPI 1629231204
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1619960721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "address_2": "2ND FL",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "address_2": "PATHOLOGY DEPT",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "191793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Joan Fay, M.S.
• Ma Eliza Fay
• Macee Fay
• Fayza S.a. Fayyad
• Christina T Fazio, FNP
• Anthony Fazzino
• Elizah Duncan Feathers, DPT, MPH
• Diana Marie Fecco
• Carmen J Federico, D.O.
• Erika L Fedors, APN

• Anatomic Pathology & Clinical Pathology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.