Ignazio Fazio, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA06047400 Issued in NJ

Practice address

342 Hamburg Tpke
Ste 201
Wayne, NJ 07470-2162

Phone

(973) 389-1119

Fax

(973) 389-1145

NPI assigned

Jun 28, 2005

Sex

Male

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

Specialty

NephrologyAlso: Internal Medicine

Education

State University of Ny Upstate Medical University, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Suburban Nephrology Group PAGroup PAC ID 5698712537, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Innovative Renal Care Woodland Park Dialysis facility, Woodland Park, NJ, CCN 312606
• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017
• Valley Hospital Hospital, Paramus, NJ, CCN 310012
• St. Josephs Wayne Hospital Inpatient rehabilitation facility, Wayne, NJ, CCN 31T019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ignazio.fazio@sngp-nj.direct.office.nextgen.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Suburban Nephrology Group PA

  • Specialist
  • Wayne, NJ
  • NPI 1972614022
  Medicare reassignment Care Compare group NPD

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

• Woodland Park Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Woodland Park, NJ
  • NPI 1942517073

  Dialysis facility

  Care Compare affiliation Name & address match
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation
• St Joseph'S Hospital and Medical Center

  • Rehabilitation Hospital Unit
  • Wayne, NJ
  • NPI 1609847870

  Inpatient rehabilitation facility

  Care Compare affiliation
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  Care Compare affiliation

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1972500528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE",
            "address_2": "STE 201",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702162",
            "telephone_number": "973-389-1119",
            "fax_number": "973-389-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE",
            "address_2": "STE 201",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702162",
            "telephone_number": "973-389-1119",
            "fax_number": "973-389-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "IGNAZIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA06047400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6236502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Farhad and Brijal LLC
• Reza Farhangfar, MD
• Irfan R Farhat, DDS
• Donnamarie Farraye, LPC
• Maria Favocci
• Susan J Fecko, LCSW
• Daniel P Feghhi, MD
• Jing Jing Feng, M.D.
• Victoria Andrea Ferlauto, MA
• Robert Fernand, MD

• Nephrology Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.