Edward Fancovic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

98-50 Issued in NM

Practice address

7801 Academy Rd NE
Unm Family Health Clinics, NE Heights
Albuquerque, NM 87109-3379

Phone

(505) 272-2700

Fax

(505) 272-6308

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  Medicare reassignment NPD
• Unm Medical Group, Inc.

  dba UNM Truman Health Services Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD
• Unm Medical Group Inc

  dba Center for Development & Disability

  • Developmental Disabilities Clinic/Center
  • Albuquerque, NM
  • NPI 1851614432
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1851307433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 ACADEMY RD NE",
            "address_2": "UNM FAMILY HEALTH CLINICS, NE HEIGHTS",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093379",
            "telephone_number": "505-272-2700",
            "fax_number": "505-272-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANCOVIC",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "98-50",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Smiles, LLC
• Family Smiles, LLC
• Family Workshop LCC
• Family Workshop LLC
• Familyworks, Inc
• Monthida Fangtham
• Brianna Fank, LCSW
• Michael J Fanning, D.D.S., M.S.D.
• Rachel Harms Fanning, DDS
• Stephanie Fanning

• Internal Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.