Individual provider Active NPI

Laura Faeder, FNP

  • Family Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1780041848
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180551 Issued in VA
Practice address
8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone
(571) 472-4724
Fax
(571) 472-1601
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 651820 NY
Family Nurse Practitioner 363LF0000X 2017010551 NY
Family Nurse Practitioner 363LF0000X 341996-1 NY
Family Nurse Practitioner 363LF0000X 0024180551 VA Primary

Addresses

Primary practice location

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

2525 18th St Apt 540
Denver, CO 80211-6437
Phone (703) 350-9211

Other practice location 2

1176 5th Ave
New York, NY 10029-6503
Phone (212) 241-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200819003442 NY Practitioner - Nurse Practitioner 1850642315 Reassigns benefits to 1 organization
I20210318001461 DC Practitioner - Nurse Practitioner 1850642315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
651820NYMDRegistered Nurse
2017010551NYMDFamily Nurse Practitioner
341996-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 15, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 20, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 20, 2020 Accepting new patients

Locations

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Organizations & group practices 4

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1780041848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 INNOVATION PARK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314867",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 18th St Apt 540",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802116437",
            "country_code": "US",
            "telephone_number": "703-350-9211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1176 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296503",
            "country_code": "US",
            "telephone_number": "212-241-5005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAEDER",
        "first_name": "LAURA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "651820",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "2017010551",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341996-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.