Ebtisam Faddoul, PA-C
NPI 1114294055 · Physician Assistant · Stamford, CT
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ebtisam Faddoul, PA-C is a Physician Assistant provider in Stamford, CT (NPI 1114294055).
Provider details
- NPI number
- 1114294055
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 015255-1 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 111 E 210th StBronx, NY 10467-2401Phone: (718) 920-2985Fax: (718) 920-2058
Registry dates
- Enumerated
- 2011-11-21
- Last updated
- 2022-07-19
- Certified
- 2022-07-19
Frequently asked questions
- What is Ebtisam Faddoul's NPI number?
- Ebtisam Faddoul's National Provider Identifier (NPI) is 1114294055, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ebtisam Faddoul's specialty?
- Ebtisam Faddoul is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ebtisam Faddoul located?
- Ebtisam Faddoul's practice location on file with NPPES is 29 Hospital Plz Ste 501, Stamford, CT 06902-3602.
- What is Ebtisam Faddoul's phone number?
- The practice phone number listed in the NPPES registry for Ebtisam Faddoul is (203) 276-4400.
- Does Ebtisam Faddoul accept Medicare?
- Ebtisam Faddoul is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ebtisam Faddoul's NPI active?
- Yes — Ebtisam Faddoul's NPI (1114294055) is active in the NPPES registry as of the last update on 2022-07-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.