Individual provider Active NPI

Felix Fearns, PA

  • Medical Physician Assistant
  • Staten Island, NY
National Provider Identifier
1639154560
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006332 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9158
NPI assigned
Dec 14, 2005
Last updated
Apr 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 006332 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

1 Edgewater St
Suite 723
Staten Island, NY 10305-4900
Phone (718) 226-4324

Other identifiers 1

IdentifierTypeStateIssuer
01992781MedicaidNY

Other names 1

  • Felix Fernandes Former name

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
I20060503000360 NY Practitioner - Physician Assistant 2769492883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006332NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Dec 1, 2010 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

1 Edgewater St
Ste 723
Staten Island, NY 10305

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: ffearns69408@northwell.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1639154560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "SUITE 723",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-4324",
            "fax_number": "718-226-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARNS",
        "first_name": "FELIX",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01992781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FELIX",
            "last_name": "FERNANDES",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.