Active NPI
Daniella Marie Fair, PA
- Physician Assistant
- New York, NY
National Provider Identifier
1790547610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 525 E 68TH St
New York, NY 10065-4870 - Phone
- (212) 746-5454
- NPI assigned
- Jan 25, 2024
- Last updated
- Jan 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
525 E 68TH St
New York, NY 10065-4870
Mailing address
525 E 68TH St
New York, NY 10065-4870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1790547610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 E 68TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100654870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E 68TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100654870",
"telephone_number": "212-746-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "DANIELLA",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-25",
"last_updated": "2024-01-25",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.