Individual provider Active NPI

Venis F Fanous, MD

  • Internal Medicine Physician
  • East Brunswick, NJ
National Provider Identifier
1871594432
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA 41914 Issued in NJ
Practice address
59 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone
(732) 238-3883
Fax
(732) 238-4826
NPI assigned
Aug 4, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA 41914 NJ Primary

Addresses

Primary practice location

59 Brunswick Woods Dr
East Brunswick, NJ 08816-5601

Mailing address

59 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone (732) 238-3883

Other identifiers 3

IdentifierTypeStateIssuer
4058674OtherAETNA
1304305MedicaidNJ
27614OtherUNITED

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101117000808 NJ Practitioner - Internal MedicinePractitioner - General Practice 9931394897 Practice locations: East Brunswick, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

59 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone (732) 238-3883

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Cranford, NJ, CCN 317020
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA 41914NJMDInternal Medicine Physician

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697846400000",
    "number": "1871594432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BRUNSWICK WOODS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165601",
            "telephone_number": "732-238-3883",
            "fax_number": "732-238-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 BRUNSWICK WOODS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165601",
            "telephone_number": "732-238-3883",
            "fax_number": "732-238-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANOUS",
        "first_name": "VENIS",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA 41914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4058674",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1304305",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "27614",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.