Individual provider Active NPI

Alla Fayngersh, MD

  • Internal Medicine Physician
  • Englewood, NJ
National Provider Identifier
1801816103
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07826000 Issued in NJ
Practice address
350 Engle Street
Department of Medicine
Englewood, NJ 07631
Phone
(201) 894-3690
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07826000 NJ Primary

Addresses

Primary practice location

350 Engle Street
Department of Medicine
Englewood, NJ 07631

Mailing address

350 Engle Street
Department of Medicine
Englewood, NJ 07631
Phone (201) 894-3690

Other identifiers 1

IdentifierTypeStateIssuer
0055956MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address afayngersh35481@direct.uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050303000204 NJ Practitioner - Internal Medicine 7012960909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Rochester School of Medicine and Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07826000NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Internal Medicine CurrentSince Nov 5, 2012 Accepting new patients
University Hospital Past Accepting new patients
Englewood Medical Associates, Inc Internal Medicine Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
Englewood Medical Associates Inc Past Accepting new patients

Locations

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

140 Bergen St
#F
Newark, NJ 07103
Phone (973) 972-2573

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

Organizations & group practices 5

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1801816103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE STREET",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE STREET",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYNGERSH",
        "first_name": "ALLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07826000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055956",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afayngersh35481@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.