Active NPI
Fariha Ilyas, M.D.
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 25MA12638800
- Practice address
- 150 Bergen St
Newark, NJ 07103-2496 - Phone
- (973) 972-4300
- NPI assigned
- May 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 279717 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 25MA12638800 | NJ | Primary |
Addresses
Primary practice location
150 Bergen St
Newark, NJ 07103-2496
Mailing address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Other practice location 1
157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5678
Other practice location 2
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-8515
Other practice location 3
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-8515
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | filyas301718@direct.vidanthealth.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA12638800 | NJ | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current | Accepting new patients |
Locations
2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
Interoperability endpoints
- filyas301718@direct.vidanthealth.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Greenville, NC
- NPI 1477648731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1689029209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032496",
"telephone_number": "973-972-4300"
}
],
"practiceLocations": [
{
"address_1": "157 Union St",
"address_purpose": "LOCATION",
"city": "Marlborough",
"state": "MA",
"postal_code": "017521228",
"country_code": "US",
"telephone_number": "508-486-5678",
"fax_number": "508-486-5677",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550002",
"country_code": "US",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ILYAS",
"first_name": "FARIHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-02",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "279717",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NJ",
"license": "25MA12638800",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "filyas301718@direct.vidanthealth.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "2100 Stantonsburg Rd",
"city": "Greenville",
"state": "NC",
"country_code": "US",
"postal_code": "278342818",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.