NPIMap

Individual provider Active NPI

John A Fabian, M.D.

  • Internal Medicine Physician
  • North Tonawanda, NY
National Provider Identifier
1982635504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
186089 Issued in NY
Practice address
80 Mead St
North Tonawanda, NY 14120-4435
Phone
(716) 693-1596
Fax
(716) 743-0812
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 186089 NY Primary

Addresses

Primary practice location

80 Mead St
North Tonawanda, NY 14120-4435

Mailing address

80 Mead St
North Tonawanda, NY 14120-4435
Phone (716) 693-1596

Other identifiers 4

IdentifierTypeStateIssuer
000511201003OtherNYBC/BS OF WESTERN NEW YORK
00010052501OtherNYEXCELLUS/ UNIVERA INS. CO
01280359MedicaidNY
0403772OtherNYINDEPENDENT HEALTH INS.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000034 NY Practitioner - Internal Medicine 6901992734 Practice locations: North Tonawanda, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 Mead St
North Tonawanda, NY 14120-4435
Phone (716) 693-1596

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186089NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emilia Phillips MD PC Past Accepting new patients
Emg Spine and Sports Medicine, LLC PastSince Nov 1, 2004 Accepting new patients

Organizations & group practices 2

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 8

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982635504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MEAD ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204435",
            "telephone_number": "716-693-1596",
            "fax_number": "716-743-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MEAD ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204435",
            "telephone_number": "716-693-1596",
            "fax_number": "716-743-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "186089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF WESTERN NEW YORK",
            "identifier": "000511201003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS/ UNIVERA INS. CO",
            "identifier": "00010052501",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01280359",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH INS.",
            "identifier": "0403772",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.