Fatoumata Haidara Camara, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA061473 Issued in PA

Practice address

50 Monument Rd
Bala Cynwyd, PA 19004-1723

Phone

(610) 668-2570

NPI assigned

May 29, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennsylvania Centre for Dermatology, LLCGroup PAC ID 4183603335, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pennsylvania Centre for Dermatology, LLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1861501801
  Medicare reassignment Care Compare group
• Lynn M. Klein, M.D., L.L.C.

  • Dermatology Physician
  • Wynnewood, PA
  • NPI 1326162637
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1033733670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 HENRY AVE APT 1M",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281503",
            "telephone_number": "267-980-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MONUMENT RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041723",
            "telephone_number": "610-668-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARA",
        "first_name": "FATOUMATA",
        "middle_name": "HAIDARA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OA005197",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MA061473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://doctor.klara.com/#/login",
            "affiliation": "N",
            "endpointDescription": "Provider/Patient messaging portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "50 Monument Rd",
            "city": "Bala Cynwyd",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190041723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katharine Grace Burke, AGPCNP
• Cabana Behavioral Health LLC
• Heather Caggiano
• Alyssa Callaway, MS
• Michelle Shannon Calvani, OTR/L
• Joseph J Cammarata, D.C.
• Rahmanda Salamatu Campbell
• Robert Campbell, P.T.
• Melissa Cappelli
• Richard Christopher Cappo, BCBA

• Dermatology Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.