Ronald C. Fagan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

178331 Issued in NY

Practice address

4900 Hempstead Tpke
Farmingdale, NY 11735-2028

Phone

(516) 752-7000

Fax

(516) 586-8644

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Internal MedicineAlso: Gastroenterology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ronald C Fagan MD PCGroup PAC ID 5991697823, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Ronald C Fagan MD, PC

  • Specialist
  • Farmingdale, NY
  • NPI 1023146198
  Medicare reassignment Care Compare group Authorized official
• Ronald C Fagan MD PC

  • Family Medicine Physician
  • Little Neck, NY
  • NPI 1134280142
  NPD
• South Shore Family Medical Associates, P.C.

  • Family Medicine Physician
  • Inwood, NY
  • NPI 1720122716
  NPD (past)

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

• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1972524486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 HEMPSTEAD TPKE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352028",
            "telephone_number": "516-752-7000",
            "fax_number": "516-586-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 HEMPSTEAD TPKE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352028",
            "telephone_number": "516-752-7000",
            "fax_number": "516-586-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "RONALD",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "178331",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "178331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01291969",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03367237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Farmingdale Adult Day Care Center Inc
• Farmingdale Dental Group PC

• Internal Medicine Physician in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.