Individual provider Active NPI

Matthew S Fabian, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, NY
National Provider Identifier
1922565001
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
599246-1 Issued in NY
Practice address
57 N Harrison St
Johnson City, NY 13790-1476
Phone
(607) 763-6000
NPI assigned
Feb 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 599246-1 NY Primary

Addresses

Primary practice location

57 N Harrison St
Johnson City, NY 13790-1476

Mailing address

156 Corliss Ave Apt 107
Johnson City, NY 13790-2071
Phone (607) 763-6735

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610002153 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486681988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Health Services Hospitals, Inc.Group PAC ID 5193610533, 471 clinicians

Practice addresses (Care Compare)

10 -24 Mitchell Ave
Binghamton, NY 13903-1617
Phone (607) 762-2468

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
599246-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jun 1, 2019 Accepting new patients

Locations

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

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.

Hospital & facility affiliations 1

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1922565001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE APT 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902071",
            "telephone_number": "607-763-6735",
            "fax_number": "607-763-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 N HARRISON ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901476",
            "telephone_number": "607-763-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "599246-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.