Active NPI
Marie Fazzary, MD
- Gastroenterology Physician
- Bradenton, FL
National Provider Identifier
1861481475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME0064513
- Practice address
- 101 Riverfront Blvd Ste 700
Bradenton, FL 34205-8823 - Phone
- (941) 748-2417
- Fax
- (941) 748-3694
- NPI assigned
- Oct 17, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME0064513 | FL | Primary |
Addresses
Primary practice location
101 Riverfront Blvd Ste 700
Bradenton, FL 34205-8823
Mailing address
101 Riverfront Blvd Ste 700
Bradenton, FL 34205-8823
Phone (941) 748-2417
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110078702 | Other | RAILROAD MEDICARE | |
| 5339083 | Other | AETNA PPO | |
| 23540 | Other | FL | BLUECROSS BLUE SHIELD |
| 6956161004 | Other | CIGNA | |
| 968688 | Other | AETNA HMO | |
| 29-05295 | Other | UNITED HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538956800000",
"number": "1861481475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 RIVERFRONT BLVD STE 700",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058823",
"telephone_number": "941-748-2417",
"fax_number": "941-748-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 RIVERFRONT BLVD STE 700",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058823",
"telephone_number": "941-748-2417",
"fax_number": "941-748-3694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZZARY",
"first_name": "MARIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-17",
"last_updated": "2018-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME0064513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110078702",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5339083",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "23540",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6956161004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "968688",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "29-05295",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.