Tina M Fadil

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA50418 Issued in NJ

Practice address

24 Elm St
Harrington Park, NJ 07640-1902

Phone

(201) 784-0123

Fax

(201) 784-0065

NPI assigned

Aug 12, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tfadil236685@direct.englewoodhealth.org

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.

• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment NPD

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1932101516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ELM ST",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401902",
            "telephone_number": "201-784-0123",
            "fax_number": "201-784-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ELM ST",
            "city": "HARRINGTON PARK",
            "state": "NJ",
            "postal_code": "076401902",
            "telephone_number": "201-784-0123",
            "fax_number": "201-784-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADIL",
        "first_name": "TINA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA50418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "P00422883",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine Deserio, AGPCNP-BC
• James Howard Dykstra, D.D.S
• Eiegc
• Everas Community Services, Inc.
• Everas Community Services, Inc.
• Christine Fingeroth, PSY.D.
• Fordham-Lewis Consulting, L.L.C.
• General Technix LLC
• Michael Francis Giannantonio, RPH
• Health Life Acupuncture LLC

• Internal Medicine Physician in Harrington Park, NJ
• Providers in Harrington Park, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.