Individual provider Active NPI

Fahad Ali, MD

  • Psychiatry Physician
  • Bryn Mawr, PA
National Provider Identifier
1053622969
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD456323 Issued in PA
Practice address
860 W Lancaster Ave
Bryn Mawr, PA 19010-3229
Phone
(484) 297-9030
Fax
(484) 297-9030
NPI assigned
Jun 24, 2010
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X MD456323 PA
Psychiatry Physician 2084P0800X MD456323 PA Primary
Psychiatry Physician 2084P0800X D76364 MD
Child & Adolescent Psychiatry Physician 2084P0804X MD456323 PA

Addresses

Primary practice location

860 W Lancaster Ave
Bryn Mawr, PA 19010-3229

Mailing address

860 W Lancaster Ave
Bryn Mawr, PA 19010-3229
Phone (484) 297-9030

Other practice location 1

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 273-8871

Other practice location 2

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 821-8017

Other practice location 3

1001 S George St
York, PA 17403-3676
Phone (717) 851-2304

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208001247 PA Practitioner - Psychiatry 8628396942 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD456323PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven Psychiatry CurrentSince Oct 26, 2022 Accepting new patients
Penn Foundation Inc CurrentSince Sep 1, 2016 Accepting new patients
Wellspan Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Uhs of Pennsylvania Inc Psychiatry Current Accepting new patients
Uhs of Pennsylvania Inc Psychiatry CurrentSince Oct 23, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Eastern Pennsylvania Physician Alliance LLC Child & Adolescent Psychiatry CurrentSince Jun 1, 2020 Accepting new patients
Philhaven CurrentSince Oct 26, 2022 Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

6375 Chambersburg Rd
Fayetteville, PA 17222
Phone (717) 352-2721

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

283 S Butler Rd
Lebanon, PA 17042

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

807 Lawn Ave
Sellersville, PA 18960

1001 S George St
York, PA 17403
Phone (717) 812-7687

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: fali277050@wellspan.direct-ci.com

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1053622969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 W LANCASTER AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103229",
            "telephone_number": "484-297-9030",
            "fax_number": "484-297-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 W LANCASTER AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103229",
            "telephone_number": "484-297-9030",
            "fax_number": "484-297-9030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-821-8017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-851-2304",
            "fax_number": "717-851-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "FAHAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "PA",
            "license": "MD456323",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD456323",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D76364",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD456323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.