Amin Fazeli, MD is a medicare enrolled "Dermatology" physician in Fayetteville, New York. He went to Yale University School Of Medicine and graduated in 2001 and has 23 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Dr. Fazeli And Dr. Broumand Llc and his current practice location is
4110 Medical Center Dr, Suite 110, Fayetteville, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 663-0100.
Amin Fazeli is licensed to practice in New York (license number 236051) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215991005.
Physician's Profile
| Full Name | Amin Fazeli |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 23 Years |
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| Location | 4110 Medical Center Dr, Fayetteville, New York |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Amin Fazeli attended and graduated from Yale University School Of Medicine in 2001
NPI Data:
- NPI Number: 1215991005
- Provider Enumeration Date: 04/17/2006
- Last Update Date: 01/26/2017
Medicare PECOS Information:
- PECOS PAC ID: 7416981253
- Enrollment ID: I20050921000913
Medical Identifiers
Medical identifiers for Amin Fazeli such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215991005 | NPI | - | NPPES |
| RA7948 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 236051 (New York) | Primary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 236051 (New York) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Dr. Fazeli And Dr. Broumand Llc | 0446358063 | 9 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amin Fazeli allows following entities to bill medicare on his behalf.
| Entity Name | Dr. Fazeli & Dr. Broumand Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336235639
PECOS PAC ID: 0446358063
Enrollment ID: O20070606000029 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amin Fazeli is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amin Fazeli, MD
4110 Medical Center Dr, Dermatology Associates Of Cny Pllc,
Fayetteville, NY 13066-6613
Ph: (315) 663-0100 | Amin Fazeli, MD
4110 Medical Center Dr, Suite 110,
Fayetteville, NY 13066-6613
Ph: (315) 663-0100 |
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