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ANITA FAZELI DO
NPI 1376232009
Student in an Organized Health Care Education/Training Program in Jacksonville, FL

Active since May 08, 2023PECOS Enrolled
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204(904) 308-7372 Get Directions Write a Review

NPPES record last updated: May 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Anita Fazeli Do NPPES

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

ANITA FAZELI DO (NPI 1376232009) is an individual student in an organized health care education/training program in Jacksonville, Florida and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of William Carey University College Of Osteopathic Medicine (2023).

NPPES Registry Identity

NPI1376232009
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameANITA FAZELICredential: DO
Location Address2627 RIVERSIDE AVEJacksonville, FL 32204-4717
Mailing Address2627 Riverside AveJacksonville, FL 32204-4717 · (904) 308-7372
Phone(904) 308-7372
Sole ProprietorYes
Medical School CMSWilliam Carey University College Of Osteopathic MedicineGraduated 2023
Enumeration DateMay 8, 2023
NPPES CertifiedMay 8, 2023
✔ NPI 1376232009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
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.
2627 RIVERSIDE AVE, Jacksonville, FL 32204
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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)

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

PECOS PAC ID5698110625
PECOS Enrollment IDI20260529000519
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.

SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Physical Therapist
2627 RIVERSIDE AVE, 3RD FLOOR
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
DR. HANAIN FAZAL DO
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
YVONNE NYAKIO KAMAU MD
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
DANIEL B TEAHAN PT
Physical Therapist
2627 RIVERSIDE AVE, SUITE 300
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
WYNONA FRANCHESCA DIZON
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
MRS. SONYA JEAN DOMINGUEZ M.D.
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372
KRISTEN M. CURTIS PT
Physical Therapist (Orthopedic)
2627 RIVERSIDE AVE, SUITE 300
JACKSONVILLE, FL 32204
Duval County (904) 634-0640
FARADIA PIERRE MD
Family Medicine
2627 RIVERSIDE AVE
JACKSONVILLE, FL 32204
Duval County (904) 308-7372

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 Anita Fazeli's NPI number?

The NPI number for Anita Fazeli is 1376232009. It was assigned to this individual provider in the NPPES registry on May 8, 2023.

Where is Anita Fazeli located?

Anita Fazeli practices at 2627 Riverside Ave, Jacksonville, FL 32204. The listed phone number is (904) 308-7372.

What is Anita Fazeli's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Anita Fazeli enrolled in Medicare?

Yes. Anita Fazeli is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Anita Fazeli was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.