Ebtisam Faddoul, PA-C

Physician Assistant · Stamford, CT

Call (203) 276-4400 Directions

At a glance

29 Hospital Plz Ste 501, Stamford, CT 06902-3602

NPPES record updated Jul 19, 2022. Public records can lag behind changes at a practice.

Before you call: a quick checklist
  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Medicare & insurance

Insurance participation is not established by these public records. Ask the practice and your insurer about your specific plan and this location.

How to check your coverage

Use your plan’s provider directory or the member-services number on your insurance card. Confirm the clinician, practice address, service, and whether a referral is required. A missing opt-out record does not establish Medicare acceptance.

Check the official Medicare directory ↗

Practice location

29 Hospital Plz Ste 501
Stamford, CT 06902-3602

Additional reported practice locations

111 E 210Th St
Bronx, NY 104672401
Phone: 7189202985
Fax: 7189202058
REPORTED BACKGROUND

Education & affiliations

Medical / professional school
Mercy College
Graduation year
2011
CMS specialties
Physician Assistant

Practice groups

Graduation year does not establish years in practice. A reported affiliation does not establish employment, current admitting privileges, or insurance participation.

Source: CMS National Downloadable File · Published Oct 15, 2026.

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PUBLISHED MEDICARE ACTIVITY

Procedures in the public data

Reported activity can help you ask more informed questions about a practice’s services.

No displayed procedure-category record in this release. This does not mean the clinician performs no procedures.

CMS uses a one-year claims window with a reporting lag. Counts cover the Medicare activity included by CMS, not all patients. “1–10” is a published range. Volume is not a quality or outcomes score. Coverage and methodology

Source: CMS Utilization Data · Published Oct 15, 2026.

Service-mix comparison is unavailable for this NPI in the imported Medicare service file.

PAYMENT TRANSPARENCY

Industry-reported general payments

No matching general-payment summary in the imported release. This is not a verified zero and does not rule out other payment types or years.

Source: CMS 2025 payments grouped by covered recipient and nature of payments · Published Jun 30, 2026.

Professional details: NPI, taxonomy & registry record
NPI1114294055
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Registry details

Primary taxonomy
Physician Assistant
Taxonomy code
363A00000X
Enumeration date
Nov 21, 2011
Record updated
Jul 19, 2022
More registry details
Provider type
Individual · Type 1
Reported credentials
PA-C

Reported taxonomies and licenses

Physician Assistant

363A00000X · Primary

License reported: 015255-1 NY

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

29 Hospital Plz Ste 501
Stamford, CT 06902-3602
Phone
(203) 276-4400
Fax
(203) 276-4401
Mailing address
29 HOSPITAL PLZ STE 501

STAMFORD, CT 069023602
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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