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FADWA MINI
NPI 1154039477
Physician Assistant - Surgical in Brooklyn, NY

Active since November 07, 2022PECOS Enrolled
450 CLARKSON AVE # 67, BROOKLYN, NY 11203(718) 270-1000 Get Directions Write a Review

NPPES record last updated: July 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 30, 2024, Nov 7, 2022 (2 updates tracked since 2022).

About Fadwa Mini NPPES

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

FADWA MINI (NPI 1154039477) is an individual surgical provider in Brooklyn, New York and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154039477
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameFADWA MINI
Location Address450 CLARKSON AVE # 67Brooklyn, NY 11203-2012
Mailing Address263 Farmington AveFarmington, CT 06030-1921 · (860) 679-2147 · Fax (860) 679-4624
Phone(718) 270-1000
Sole ProprietorNo
Enumeration DateNovember 7, 2022
Last NPPES UpdateJuly 30, 20242 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1154039477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
450 CLARKSON AVE # 67, Brooklyn, NY 11203
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fadwa Mini 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 11

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

MICHAEL YUDELL DO
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
CHARISSE ROSARIO PA
Physician Assistant (Medical)
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
MIR SULAYMAN ALI KHAN MD
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
MR. OWEN WASHINGTON EDWARDS JR. MD
Registered Nurse
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
MS. ERIKA LAWRENCE RN, CFNP
Nurse Practitioner
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 240-2700
SRIVANE RICHARD MBBS
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
DR. JAN JAVIER JIMENEZ SANTIAGO MD
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (718) 270-1000
DR. DEA THOMAS MBBS
Student in an Organized Health Care Education/Training Program
450 CLARKSON AVE # 67
BROOKLYN, NY 11203
Kings County (719) 270-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fadwa Mini's NPI number?

The NPI number for Fadwa Mini is 1154039477. It was assigned to this individual provider in the NPPES registry on November 7, 2022.

Where is Fadwa Mini located?

Fadwa Mini practices at 450 Clarkson Ave # 67, Brooklyn, NY 11203. The listed phone number is (718) 270-1000.

What is Fadwa Mini's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Fadwa Mini enrolled in Medicare?

Yes. Fadwa Mini is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fadwa Mini was last updated on July 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.