Individual provider Active NPI

Farrukh Javed, MD

  • Neonatal-Perinatal Medicine Physician
  • Albany, NY
National Provider Identifier
1902526692
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
310527 Issued in NY
Practice address
315 S Manning Blvd
Albany, NY 12208-1707
Phone
(518) 525-6560
Fax
(518) 944-2534
NPI assigned
Sep 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 310527 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
Albany, NY 12208-1707

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220922000268 NY Practitioner - Pediatric Medicine 8123403441 Reassigns benefits to 1 organization
I20240313000763 ND Practitioner - Pediatric Medicine 8123403441 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310527NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Mar 1, 2024 Accepting new patients
Altru Health System CurrentSince Mar 1, 2024 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Jun 3, 2022 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Jun 3, 2022 Accepting new patients
Altru Health System Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients

Locations

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

315 S Manning Blvd
Rm 3563C
Albany, NY 12208
Phone (518) 525-6560

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1902526692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-6560",
            "fax_number": "518-944-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVED",
        "first_name": "FARRUKH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "310527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.