FADY BOTROS DO
NPI 1053107581
Student in an Organized Health Care Education/Training Program in Fayetteville, NC

Active since April 21, 2025PECOS Enrolled
1638 OWEN DR, FAYETTEVILLE, NC 28304(915) 615-4000 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Fady Botros Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FADY BOTROS DO (NPI 1053107581) is an individual student in an organized health care education/training program in Fayetteville, North Carolina and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053107581
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameFADY BOTROSCredential: DO
Location Address1638 OWEN DRFayetteville, NC 28304-3424
Mailing Address1638 Owen DrFayetteville, NC 28304-3424 · (915) 615-4000
Sole ProprietorYes
Enumeration DateApril 21, 2025
NPPES CertifiedApril 20, 2025
NPI 1053107581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1638 OWEN DR, Fayetteville, NC 28304

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Fady Botros Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1638 OWEN DR
FAYETTEVILLE, NC 28304
Internal Medicine
1638 OWEN DR
FAYETTEVILLE, NC 28304
Emergency Medicine
1638 OWEN DR
FAYETTEVILLE, NC 28304
Family Medicine
1638 OWEN DR
FAYETTEVILLE, NC 28304
Nurse Anesthetist, Certified Registered
1638 OWEN DR
FAYETTEVILLE, NC 28304
Nurse Anesthetist, Certified Registered
1638 OWEN DR
FAYETTEVILLE, NC 28304
Nurse Anesthetist, Certified Registered
1638 OWEN DR
FAYETTEVILLE, NC 28304
Emergency Medicine
1638 OWEN DR
FAYETTEVILLE, NC 28304

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053107581, enumerated as an "individual" on April 21, 2025.

The provider is located at 1638 OWEN DR FAYETTEVILLE, NC 28304 and the phone number is (915) 615-4000.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.