MR. DAMIEN T FAILLACE PA-C
NPI 1164728838
Physician Assistant - Surgical in Middletown, NY

Q: What is Damien Faillace's NPI number?

The NPI number for Damien Faillace is 1164728838. It was assigned to this individual provider in the NPPES registry on January 28, 2011.

Q: What is Damien Faillace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Damien Faillace was last updated on April 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since January 28, 2011PECOS Enrolled

707 E MAIN ST, MIDDLETOWN, NY 10940(845) 333-7575(845) 333-1454 Get Directions Write a Review

NPPES record last updated: April 16, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 16, 2018, Sep 30, 2015 (2 updates tracked since 2015).

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About Mr. Damien T Faillace Pa-c NPPES

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

MR. DAMIEN T FAILLACE PA-C (NPI 1164728838) is an individual surgical provider in Middletown, New York, licensed in New York (014579) and active in the NPI registry since January 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164728838

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. DAMIEN T FAILLACECredential: PA-C

Location Address707 E MAIN STMiddletown, NY 10940-2650

Mailing Address707 E Main StMiddletown, NY 10940-2650 · (845) 333-7575 · Fax (845) 333-1454

Phone(845) 333-7575

Fax(845) 333-1454

Sole ProprietorNo

Enumeration DateJanuary 28, 2011

Last NPPES UpdateApril 16, 20182 updates tracked since enumeration

✔ NPI 1164728838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in NY · 014579

Also ListedPhysician AssistantTaxonomy 363A00000X · License 014579 (NY)

707 E MAIN ST, Middletown, NY 10940

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Other Identifiers 1

Medicaid03656622NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Damien T Faillace Pa-c 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.

KRASSIMIR ATANASSOV MD

Surgery (Surgical Critical Care)