Habib M Fanny, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD197395 Issued in OR

Practice address

1255 Hilyard St
Eugene, OR 97401-3718

Phone

(541) 686-7300

NPI assigned

Jun 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mohamed H Fanny Former name

Medicare fee-for-service enrollment

Enrolled in OR, MN, CO3 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 3

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
• St Cloud Hospital Inpatient Rehabilitation Unit Inpatient rehabilitation facility, St. Cloud, MN, CCN 24T036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hfanny872884@direct.centracare.com

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment Care Compare group NPD
• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287
  Medicare reassignment NPD
• Peacehealth Medical Group

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260

  Physical Medicine & Rehabilitation

  NPD
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  NPD
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  NPD
• Peacehealth

  • Rehabilitation Hospital Unit
  • Springfield, OR
  • NPI 1316711633
  NPD (past)
• St. Cloud Hospital

  • Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1619934627
  NPD (past)

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

• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  • Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1619934627

  Inpatient rehabilitation facility

  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1164837639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7188",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482070188",
            "telephone_number": "734-626-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HILYARD ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013718",
            "telephone_number": "541-686-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Austin Peay Hwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381282502",
            "country_code": "US",
            "telephone_number": "734-626-4663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-222-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANNY",
        "first_name": "HABIB",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD197395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMED",
            "last_name": "FANNY",
            "middle_name": "H",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annette Fallian, LAC
• Rebecca Rose Fallihee, MS, CNS
• Family Vision Center, Inc
• Helen Rebecca Fanning
• Jessica Lena Fanning, PHD, CCC-SLP
• Sarah Farish, PSS
• Keyhan Farkhondepay-Aryah, MD
• Kimberly Farley
• Mark Timothy Farley, M.ED., M.F.T.
• Alexander M Farmer

• Physical Medicine & Rehabilitation Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Physical Medicine & Rehabilitation Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.