Shamy Bushra Fazal, DPM

Primary specialty

Sports Medicine PodiatristTaxonomy code 213ES0000X

License

071069-00 Issued in NY

Practice address

210 E 86TH St RM 402
New York, NY 10028-7726

Phone

(212) 628-4444

NPI assigned

Jun 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1811512361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 86TH ST STE 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100283023",
            "telephone_number": "212-628-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 86TH ST RM 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287726",
            "telephone_number": "212-628-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZAL",
        "first_name": "SHAMY",
        "middle_name": "BUSHRA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "071069-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Charles Fayne, PH.D.
• Ruby Fayorsey, MD
• Humora Fayzullaeva
• Renata Fayzullina
• Mohamed Akil Fazal, MD
• Shazma Fazal, BSCOT
• Cynthia Drew Fazekas Young, DMD
• Mahdiya Fazel
• Sahar Fazel, DDS
• Maryann Fazio Heimrath, LCSW

• Podiatrist in New York, NY
• Providers in New York, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.