DR. ROBERT G FAFALAK MD
NPI 1982683041
Internal Medicine - Rheumatology in New York, NY

Active since January 17, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 33D2037566 · Waiver
83.26/100
CMS Quality Rating
4 LEXINGTON AVE, 1S, NEW YORK, NY 10010(212) 533-2760(212) 387-9143 Get Directions Write a Review

NPPES record last updated: March 1, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Robert G Fafalak Md NPPES

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

DR. ROBERT G FAFALAK MD (NPI 1982683041) is an individual rheumatology provider in New York, New York, licensed in New York (175702) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through March 26, 2027, and is affiliated with New York-presbyterian Hospital.

NPPES Registry Identity

NPI1982683041
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDR. ROBERT G FAFALAKCredential: MD
Location Address4 LEXINGTON AVE, 1SNew York, NY 10010-5416
Mailing Address36 West 9th St, First FloorNew York, NY 10011 · (917) 364-9398 · Fax (212) 452-1981
Fax(212) 387-9143
Sole ProprietorYes
Medical School CMSNew York Medical CollegeGraduated 1987
Enumeration DateJanuary 17, 2006
Last NPPES UpdateMarch 1, 2012
NPI 1982683041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License Licensed in NY · 175702
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
4 LEXINGTON AVE, New York, NY 10010

Other Identifiers 3

Medicare ID-Type Unspecified52F391NY
Medicaid01194027NY
Medicare UPINE62367NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert G Fafalak Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890826184
PECOS Enrollment IDI20100630000693
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2037566

Robert Fafalak, MD · New York, NY
Active · expires Mar 26, 2027
CLIA Number33D2037566
Laboratory TypePhysician Office
Certificate Effective DateJanuary 7, 2021
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Robert Fafalak
Laboratory Phone(212) 933-0072
Laboratory LocationRobert Fafalak, MD36 West 9th Street, 1st Floor, New York, NY 10011
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,597 services144 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
1,380 services14 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,026 services318 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
996 services285 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
492 services273 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
475 services268 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

New York-Presbyterian Hospital

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330101
Location525 East 68th StreetNew York, NY 10065 · New York County
Emergency services Birthing friendly

Lenox Hill Hospital

Acute Care Hospitals · New York, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330119
Location100 East 77th StreetNew York, NY 10021 · New York County
Emergency services Birthing friendly

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330214
Location550 First AvenueNew York, NY 10016 · New York County
Emergency services Birthing friendly

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality82.57
Promoting Interoperability100
Improvement Activities40
Cost61.64

Reported Quality Measures

Advance Care Plan
81%550 patients4/55-star benchmark: 100%
Controlling High Blood Pressure
78%77 patients4/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
85%4,614 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
88%1,276 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
100%732 patients5/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Functional Status Assessment
100%20 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier20 claims20 services$41.48 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

Internal Medicine
4 LEXINGTON AVE, SUITE 1S
NEW YORK, NY 10010
Dentist
4 LEXINGTON AVE, APT. 1 NP
NEW YORK, NY 10010

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 Robert Fafalak's NPI number?

The NPI number for Robert Fafalak is 1982683041. It was assigned to this individual provider in the NPPES registry on January 17, 2006.

Where is Robert Fafalak located?

Robert Fafalak practices at 4 Lexington Ave 1S, New York, NY 10010. The listed phone number is (212) 533-2760.

What is Robert Fafalak's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Robert Fafalak enrolled in Medicare?

Yes. Robert Fafalak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Robert Fafalak hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2037566) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Robert Fafalak affiliated with any hospitals?

According to CMS data, Robert Fafalak is affiliated with New York-Presbyterian Hospital, Lenox Hill Hospital, Nyu Langone Hospitals and Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Robert Fafalak was last updated on March 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.