Individual provider Active NPI

Mitchell Fahrenkrog, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1962865089
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
295461 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5506
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036154871 IL
Anesthesiology Physician 207L00000X 295461 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 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
I20200403001381 NY Practitioner - Anesthesiology 3870922339 Reassigns benefits to 2 organizations
I20230206001660 IL Practitioner - Anesthesiology 3870922339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia LLPGroup PAC ID 7719885771, 427 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7679
Phone (718) 590-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295461NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Anesthesiology CurrentSince Jun 1, 2020 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Dec 1, 2022 Accepting new patients
New York University Anesthesiology Current Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jul 8, 2022 Accepting new patients
New York University CurrentSince Jun 1, 2020 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

7 Southwoods Blvd
Ste 4
Albany, NY 12211

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

300 Community Dr
Plandome, NY 11030

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 5

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1962865089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENKROG",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036154871",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "295461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.