Sofia M Fagan, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2410 Fire Mesa St Ste 180
Las Vegas, NV 89128-9017

Phone

(702) 992-6875

NPI assigned

May 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mass General Brigham Medical Group Northern Massachusetts IncGroup PAC ID 3577467224, 817 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
• Care Dimensions, Inc Hospice, Danvers, MA, CCN 221522
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
• Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fagan.sofia.nsmc@direct.partners.masshiway.net

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.

• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment Care Compare group NPD

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

• Care Dimensions, Inc.

  • Community Based Hospice Care Agency
  • Danvers, MA
  • NPI 1447344130
  Care Compare affiliation Name & address match
• Mass General Brigham Home Care, Inc.

  • Home Health Agency
  • Newton, MA
  • NPI 1083644017
  Care Compare affiliation Name & address match
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation
• The Spaulding Rehabilitation Hospital Corporation

  • Rehabilitation Hospital
  • Charlestown, MA
  • NPI 1780600825

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1912266222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 FIRE MESA ST STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289017",
            "telephone_number": "702-992-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 FIRE MESA ST STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891289017",
            "telephone_number": "702-992-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "SOFIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "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": []
}

• Dyna Faelnar
• Leah Carmel Cortes Faelnar
• Andrew Faga
• Sheyane Faga
• Sope Jr Faga
• Kanyia Fagans
• Kelsie Cherisse Macalma Fagaragan, FNP-C
• Blayson A Fagbodun
• Molly Alma Fager, RN
• Ronald D Faggins, M.ED

• Student in an Organized Health Care Education/Training Program in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Student in an Organized Health Care Education/Training Program in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; 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.

Verify at the official NPI Registry.