NPIMap

Individual provider Active NPI

Michael Babila Fogam, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1710475348
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
311517 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-8158
NPI assigned
Apr 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 311517 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

1356 Greenridge Ave
Lithonia, GA 30058-2210
Phone (912) 401-3325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230210001157 NY Practitioner - Emergency Medicine 9638541071 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

4535 Dressier Rd NW
Canton, OH 44718-2545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Upstate Ny Physician PLLC Emergency Medicine CurrentSince Nov 1, 2025 Accepting new patients
New York University CurrentSince Jul 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Emergency Medicine CurrentSince Nov 5, 2022 Accepting new patients

Locations

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#2260
New York, NY 10032
Phone (212) 305-6204

Interoperability endpoints

  • Direct secure messaging: mfogam556338@nyumc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1710475348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 GREENRIDGE AVE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300582210",
            "telephone_number": "912-401-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGAM",
        "first_name": "MICHAEL",
        "middle_name": "BABILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "311517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.