B Fajardo MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

163674 Issued in NY

Legal business name

B FAJARDO MD PC

Practice address

140 Wadsworth Ave Apt 3
New York, NY 10033-4817

Phone

(212) 543-9700

Fax

(212) 543-1357

NPI assigned

Jan 24, 2014

Organization subpart

No

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

Authorized official

Name

Bienvenido Fajardo, M.D.NPI 1528153467

Title

Medical Director

Phone

(212) 543-9700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 4

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

• Bienvenido Fajardo, M.D.

  • Internal Medicine Physician
  • New York, NY
  • NPI 1528153467
  Medicare reassignment NPD Authorized official
• Melissa Fajardo, M.D.

  • Nephrology Physician
  • New York, NY
  • NPI 1174955579

  Internal Medicine

  Medicare reassignment NPD
• Luis Osorio Diaz, NP

  • Family Nurse Practitioner
  • New York, NY
  • NPI 1578382974
  Medicare reassignment NPD
• Yeimy Yohanna Hidalgo, PA

  • Medical Physician Assistant
  • New York, NY
  • NPI 1184907610
  NPD (past)

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1770906802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WADSWORTH AVE APT 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334817",
            "telephone_number": "212-543-9700",
            "fax_number": "212-543-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WADSWORTH AVE APT 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334817",
            "telephone_number": "212-543-9700",
            "fax_number": "212-543-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B FAJARDO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "BIENVENIDO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-543-9700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "163674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.