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

Dr. Fausto Ricardo Cabezas Bolanos, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366094088

Dr. Fausto Ricardo Cabezas Bolanos, MD is a Nephrology in Brooklyn, New York. Qualified in 2015, 11 years ago. Practices with Tjh Medical Services PC, a 213-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
11
Licensed in
NY
In the registry since
2019
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

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Brooklyn, NY

No coordinates on file. Search this address in Google Maps

Additional practice locations (2)

  • 760 Broadway, Brooklyn, NY 11206-5317 — (718) 963-8752
  • 8900 Van Wyck Expy, Jamaica, NY 11418-2897 — (718) 206-6000

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 318069-01 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366094088
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 12, 2019
Last updated in NPPESApril 18, 2024
Certification dateApril 18, 2024

Medicare enrollment

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

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Tjh Medical Services Pc — 213 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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