Individual provider Active NPI

Bushra Fazili, M.D.

  • Gastroenterology Physician
  • Rochester, NY
National Provider Identifier
1750399028
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
229574 Issued in NY
Practice address
2080 Clinton Ave South
Rochester, NY 14618
Phone
(585) 271-2800
Fax
(585) 271-0375
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 229574 NY Primary

Addresses

Primary practice location

2080 Clinton Ave South
Rochester, NY 14618

Mailing address

2080 Clinton Ave South
Rochester, NY 14618
Phone (585) 271-2800

Other identifiers 6

IdentifierTypeStateIssuer
000932679001OtherNYHEALTH NOW
203599BTOtherNYPREFERRED CARE
0164209OtherNYGHI
02878004MedicaidNY
P010229574OtherNYEXCELLUS
7485905OtherNYAETNA

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
I20071024000518 NY Practitioner - Gastroenterology 1052408978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2080 S Clinton Ave
Rochester, NY 14618-5703
Phone (585) 271-2800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy430
Upper gastrointestinal (GI) endoscopy for acid reflux169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229574NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Dec 17, 2024 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Dec 17, 2024 Accepting new patients

Locations

2080 S Clinton Ave
Rochester, NY 14618
Phone (585) 271-2800

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.

Hospital & facility affiliations 3

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1750399028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CLINTON AVE SOUTH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14618",
            "telephone_number": "585-271-2800",
            "fax_number": "585-271-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CLINTON AVE SOUTH",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14618",
            "telephone_number": "585-271-2800",
            "fax_number": "585-271-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZILI",
        "first_name": "BUSHRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "229574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000932679001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "203599BT",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0164209",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02878004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "P010229574",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7485905",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.