Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amin Fazeli, MD

Individual provider Dermatology Physician · NPI 1215991005

Amin Fazeli, MD is a Dermatology in Fayetteville, New York. Graduated from Yale University School of Medicine in 2001, 25 years ago. Practices with Dr Fazeli and Dr Broumand LLC, an 11-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
25
Trained at
Yale University School of Medicine
Licensed in
NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4110 Medical Center Dr Ste 110
Fayetteville, NY 13066-6613
Phone: (315) 663-0100
Fax: (585) 663-0052
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 236051 (NY)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence 236051 (NY)

Record details

NPI number1215991005
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2006
Last updated in NPPESJanuary 26, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Dr. Fazeli And Dr. Broumand Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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