Mary Beth Fasano, MD

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

License

35451 Issued in IA

Practice address

200 Hawkins Dr
Iowa City, IA 52242-1009

Phone

(319) 356-3692

Fax

(319) 356-8280

NPI assigned

Oct 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mfasano16491@uihcdirect.org

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1801884754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3692",
            "fax_number": "319-356-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3692",
            "fax_number": "319-356-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "35451",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "IA",
            "license": "35451",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "35451",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "04197",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0432013",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael John Farran, RPH
• Angela Tracy Farrell, MD
• Michael Thomas Farrell, MD
• Gregory Adam Farris, D.D.S.
• Khashayar Farzam, DO
• Mikenzy Fassel, MD
• Deema A Fattal, MD
• Amy Faulkner
• Aly Maher Fayed, MD, M.SC.
• Kathleen M Fear, CRNA

• Allergy & Immunology (Internal Medicine) Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Allergy & Immunology (Internal Medicine) Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.