Individual provider Active NPI

Gary Fiasconaro, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1740204536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
167199 Issued in NY
Practice address
7502 Colonial Rd
Brooklyn, NY 11209-2906
Phone
(718) 630-5770
Fax
(718) 680-2011
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 167199 NY Primary

Addresses

Primary practice location

7502 Colonial Rd
Brooklyn, NY 11209-2906

Mailing address

7502 Colonial Rd
Brooklyn, NY 11209-2906
Phone (718) 630-5770

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061104000005 NY Practitioner - Obstetrics/Gynecology 9638176696 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
167199NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Nov 28, 2016 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 28, 2016 Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

7502 Colonial Rd
Brooklyn, NY 11209
Phone (718) 630-5770

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740204536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 COLONIAL RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092906",
            "telephone_number": "718-630-5770",
            "fax_number": "718-680-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7502 COLONIAL RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092906",
            "telephone_number": "718-630-5770",
            "fax_number": "718-680-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIASCONARO",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "167199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.