Organization Active NPI

Steven D. Fayne, M.D. P.a.

  • Gastroenterology Physician
  • Sunrise, FL
National Provider Identifier
1720385362
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME0042650 Issued in FL
Legal business name
STEVEN D. FAYNE, M.D. P.A.
Practice address
8890 W Oakland Park Blvd
100
Sunrise, FL 33351-7235
Phone
(954) 741-3305
Fax
(954) 741-3306
NPI assigned
Feb 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Shawn Bradley
Title
Office Manager
Phone
(954) 741-3305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME0042650 FL Primary

Addresses

Primary practice location

8890 W Oakland Park Blvd
100
Sunrise, FL 33351-7235

Mailing address

8890 W Oakland Park Blvd
100
Sunrise, FL 33351-7235
Phone (954) 741-3305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110607000678 FL Part B Supplier - Clinic/Group Practice 9133306780 Receives reassigned benefits from 2 practitioners
Practice locations: Lauderdale Lakes, FL; Plantation, FL; Sunrise, FL; Weston, FL

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1720385362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 W OAKLAND PARK BLVD",
            "address_2": "100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517235",
            "telephone_number": "954-741-3305",
            "fax_number": "954-741-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 W OAKLAND PARK BLVD",
            "address_2": "100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517235",
            "telephone_number": "954-741-3305",
            "fax_number": "954-741-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN D. FAYNE, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-741-3305"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0042650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.