Dr Matthew Fanous, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Newark, New Jersey. His current practice location is
150 Bergen St, Newark, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(973) 972-4300.
Dr Matthew Fanous is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1841759859.
Physician's Profile
| Full Name | Dr Matthew Fanous |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 150 Bergen St, Newark, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1841759859
- Provider Enumeration Date: 03/19/2019
- Last Update Date: 12/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 6608103940
- Enrollment ID: I20221215002020
Medical Identifiers
Medical identifiers for Dr Matthew Fanous such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841759859 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 318774 (New York) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Dr Matthew Fanous allows following entities to bill medicare on his behalf.
| Entity Name | North Shore - Lij Medical Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262 |
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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. Dr Matthew Fanous 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 |
|---|
Dr Matthew Fanous, MD
300 Community Dr,
Manhasset, NY 11030-3816
Ph: (516) 562-0100 | Dr Matthew Fanous, MD
150 Bergen St,
Newark, NJ 07103-2496
Ph: (973) 972-4300 |
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