NPIMap

Individual provider Active NPI

Sheldon Fayner, MD

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1770758310
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G34800 Issued in CA
Practice address
3356 W Ball Rd
Ste 206
Anaheim, CA 92804-3702
Phone
(714) 827-8890
Fax
(714) 827-8905
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G34800 CA Primary
General Practice Physician 208D00000X G34800 CA

Addresses

Primary practice location

3356 W Ball Rd
Ste 206
Anaheim, CA 92804-3702

Mailing address

3356 W Ball Rd
Ste 206
Anaheim, CA 92804-3702
Phone (714) 827-8890

Other identifiers 2

IdentifierTypeStateIssuer
00G348000OtherCABLUE SHIELD
00G348000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080722000281 CA Practitioner - Family PracticePractitioner - General Practice 4981777190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Texas Medical Branch at Galveston, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3356 W Ball Rd
Suite 206
Anaheim, CA 92804-3728
Phone (714) 827-8890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34800CAMDGeneral Practice Dentistry
G34800CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 1

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1770758310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD",
            "address_2": "STE 206",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043702",
            "telephone_number": "714-827-8890",
            "fax_number": "714-827-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD",
            "address_2": "STE 206",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043702",
            "telephone_number": "714-827-8890",
            "fax_number": "714-827-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYNER",
        "first_name": "SHELDON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34800",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G34800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G348000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G348000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.