Active NPI
Frida Fuzailov
- Student in an Organized Health Care Education/Training Program
- Forest Hills, NY
National Provider Identifier
1891449369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 6715 102ND St Apt 3M
Forest Hills, NY 11375-2411 - Phone
- (646) 619-7142
- NPI assigned
- Feb 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
6715 102ND St Apt 3M
Forest Hills, NY 11375-2411
Mailing address
6715 102ND St Apt 3M
Forest Hills, NY 11375-2411
Phone (646) 619-7142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1308 Edward L Grant Hwy
Bronx, NY 10452-3144
Phone (718) 538-8343
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030564 | NY | MD | Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Columbus Center For Medical Rehabilitation
- Clinic/Center
- Bronx, NY
- NPI 1477570315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1891449369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6715 102ND ST APT 3M",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752411",
"telephone_number": "646-619-7142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6715 102ND ST APT 3M",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752411",
"telephone_number": "646-619-7142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUZAILOV",
"first_name": "FRIDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.