Adam Peter Fagin, D.M.D., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

103519 Issued in CA

Practice address

235 N San Mateo Dr Ste 600
San Mateo, CA 94401-2675

Phone

(650) 342-0213

NPI assigned

Jun 30, 2014

Last updated

Jan 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afagin586377@hisp.ehr.sutterhealth.org

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.

• Pofs Partnership

  dba Peninsula Oral and Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Mateo, CA
  • NPI 1699639013
  NPD Authorized official
• Richard a Fagin DDS a Professional Corporation

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Mateo, CA
  • NPI 1093474819

  Single Specialty

  NPD Authorized official
• Sutter West Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1104852789

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1740695527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N SAN MATEO DR STE 600",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012675",
            "telephone_number": "650-342-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N SAN MATEO DR STE 600",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012675",
            "telephone_number": "650-342-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGIN",
        "first_name": "ADAM",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "2020-00843",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "103519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys Fabiano
• Rowena Castanar Fabro
• Louis Joseph Facchino Jr., MDIV LMFT
• Yuliya Faccini, SUD
• Amalie Kawata Fackenthal
• Richard Agnew Fagin, DDS
• Briana T Fair
• Galan Falakfarsa
• Family Service Agency of San Mateo County
• Jennifer Fan, PSY.D., LMFT

• Oral and Maxillofacial Surgery (Dentist) in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.

Verify at the official NPI Registry.