NPIMap

Individual provider Active NPI

Mohammad Fattal, MD

  • Family Medicine Physician
  • Elsmere, KY
National Provider Identifier
1114194156
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43438 Issued in KY
Practice address
3876 Turkeyfoot Rd
Elsmere, KY 41018-2838
Phone
(859) 342-8775
NPI assigned
May 9, 2008
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43438 KY Primary

Addresses

Primary practice location

3876 Turkeyfoot Rd
Elsmere, KY 41018-2838

Mailing address

PO Box 6716
Florence, KY 41022-6716
Phone (859) 342-4087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101227000230 KY Practitioner - Family Practice 5193913796 Reassigns benefits to 1 organization
I20150701000639 OH Practitioner - Family Practice 5193913796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians

Practice addresses (Care Compare)

2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325
Phone (513) 246-7000

5861 Cinema Dr
Milford, OH 45150-1489
Phone (513) 248-8800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients
Trihealth G LLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Siraj Healthcare Incorporated Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Coldspring Transitional Care Center, LLC Past Accepting new patients
Trihealth G LLC Family Medicine Past Accepting new patients
Florence Urgent Care PastSince Jul 1, 2000 Accepting new patients
Woodcrest Operating Company LLC Past Accepting new patients
Highlandspring Health Care and Rehabilitation LLC Past Accepting new patients
Health Care Academy, Inc Past Accepting new patients

Locations

300 Plaza Dr
Cold Spring, KY 41076
Phone (859) 341-2044

3876 Turkeyfoot Rd
Erlanger, KY 41018
Phone (502) 525-6511

4220 Houston Rd
Erlanger, KY 41018
Phone (502) 525-3455

10250 US Highway 42
Union, KY 41091
Phone (502) 525-6511

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

5861 Cinema Dr
Milford, OH 45150
Phone (513) 248-8800

4685 Forest Ave
Ste C
Norwood, OH 45212
Phone (513) 246-7796

Interoperability endpoints

  • Direct secure messaging: mfattal152361@direct.trihealth.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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1114194156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6716",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410226716",
            "telephone_number": "859-342-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3876 TURKEYFOOT RD",
            "city": "ELSMERE",
            "state": "KY",
            "postal_code": "410182838",
            "telephone_number": "859-342-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTAL",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "43438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elsmere, KY

Sources for this page

Verify at the official NPI Registry.