NPIMap

Organization Active NPI

Five Towns Total Medical Care, P.C.

  • Specialist
  • Lawrence, NY
National Provider Identifier
1851319305
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FIVE TOWNS TOTAL MEDICAL CARE, P.C.
Practice address
275 Rockaway Tpke
Lawrence, NY 11559-1232
Phone
(516) 371-2225
Fax
(516) 371-3773
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Fazzini Enrico, D.O.
Title
Director/Neurologisy
Phone
(516) 371-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

275 Rockaway Tpke
Lawrence, NY 11559-1232

Mailing address

275 Rockaway Tpke
Lawrence, NY 11559-1232
Phone (516) 371-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000791 NY Part B Supplier - Clinic/Group Practice 9133182678 Receives reassigned benefits from 2 practitioners
Practice locations: Lawrence, NY

National Provider Directory

National Provider Directory

Locations

275 Rockaway Tpke
Ste B
Lawrence, NY 11559
Phone (516) 371-2225

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851319305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 ROCKAWAY TPKE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591232",
            "telephone_number": "516-371-2225",
            "fax_number": "516-371-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROCKAWAY TPKE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591232",
            "telephone_number": "516-371-2225",
            "fax_number": "516-371-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE TOWNS TOTAL MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENRICO",
        "authorized_official_first_name": "FAZZINI",
        "authorized_official_title_or_position": "DIRECTOR/NEUROLOGISY",
        "authorized_official_telephone_number": "516-371-2225",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.