Omotayo Fasan

Primary specialty

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

Practice address

72 E Concord St
Boston, MA 02118-2642

Phone

(617) 358-7477

NPI assigned

Feb 28, 2026

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1772236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772236800000",
    "number": "1912852518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 E CONCORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 E CONCORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182642",
            "telephone_number": "617-358-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1353 Dorchester Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021222932",
            "country_code": "US",
            "telephone_number": "617-288-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASAN",
        "first_name": "OMOTAYO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-28",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "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": []
}

• Yousaf Z Farukhi, MD, DMD
• Zareen M Farukhi, M.D.
• Alan P Farwell, M.D.
• Wildon R Farwell, MD
• Sheila Ann Faryman, M.D.
• Chloe Elyse Fasanmi
• Alessio Fasano, MD
• Amanda Fasano
• Samuel C Fasbinder, M.D.
• Laura C Fasciano, PSYD

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.