Individual provider Active NPI

Daniel Faybyshev, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1679384937
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033259 Issued in NY
Practice address
260 Avenue X
Brooklyn, NY 11223-5940
Phone
(718) 522-3399
Fax
(718) 522-1888
NPI assigned
Jan 16, 2025
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 033259 NY Primary

Addresses

Primary practice location

260 Avenue X
Brooklyn, NY 11223-5940

Mailing address

99 Old Amboy Rd Apt 302
Old Bridge, NJ 08857-3480
Phone (347) 853-2944

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
I20251208000872 NY Practitioner - Physician Assistant 6507359544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

200 Livingston St
Brooklyn, NY 11201-5811
Phone (718) 522-3399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033259NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc Multi-Specialty CurrentSince Nov 1, 2025 Accepting new patients
Niranjan K Mittal, Physician, PLLC Multi-Specialty PastSince Nov 1, 2025 Accepting new patients
Suny Downstate Medical Center Multi-Specialty PastSince Nov 30, 2025 Accepting new patients

Locations

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1679384937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 OLD AMBOY RD APT 302",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573480",
            "telephone_number": "347-853-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235940",
            "telephone_number": "718-522-3399",
            "fax_number": "718-522-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYBYSHEV",
        "first_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.