Emad Kamal Abdel-Fattah, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35820 Issued in TN

Practice address

1109 E Reelfoot Ave
Suite D
Union City, TN 38261-5856

Phone

(731) 884-2140

Fax

(731) 884-8998

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI, PA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654

  PA, Pediatrics

  Medicare reassignment NPD
• McLaren Thumb Region

  • General Acute Care Hospital
  • Bad Axe, MI
  • NPI 1245257880

  MI

  Medicare reassignment
• Huron Pathology Services PC

  • Pulmonary Disease Physician
  • Bad Axe, MI
  • NPI 1265546899
  NPD
• McLaren Thumb Region

  • Critical Access Hospital
  • Bad Axe, MI
  • NPI 1518991744
  NPD
• Park Family Health Care, P.C.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1437161437
  NPD (past)
• Pediatrix Medical Group of Michigan PC

  • Neonatal-Perinatal Medicine Physician
  • Sunrise, FL
  • NPI 1720185432
  NPD (past)
• Upmc Northwest

  • General Acute Care Hospital
  • Seneca, PA
  • NPI 1619069440
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1164430872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE",
            "address_2": "SUITE D",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615856",
            "telephone_number": "731-884-2140",
            "fax_number": "731-884-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE",
            "address_2": "SUITE D",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615856",
            "telephone_number": "731-884-2140",
            "fax_number": "731-884-8998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDEL-FATTAH",
        "first_name": "EMAD",
        "middle_name": "KAMAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "35820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4023312",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3899537",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22089",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jane Adams, RN
• Advanced Diagnostic Imaging, PC
• Advanced Orthopedics & Sports Medicine, PLLC
• Advanced Regional Foot Clinic PLLC
• Agilitas USA, Inc.

• All providers in Union City, TN
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.