NPIMap

Individual provider Active NPI

Ahmed Fathala, MD

  • Internal Medicine Physician
  • Clinton, IA
National Provider Identifier
1184604696
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34418 Issued in IA
Practice address
2745 Lincoln Way
Clinton, IA 52732-7201
Phone
(563) 242-3208
Fax
(563) 242-4051
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34418 IA Primary

Addresses

Primary practice location

2745 Lincoln Way
Clinton, IA 52732-7201

Mailing address

2745 Lincoln Way
Clinton, IA 52732-7201
Phone (563) 242-3208

Other identifiers 1

IdentifierTypeStateIssuer
0448019MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250217000501 OH Practitioner - Diagnostic Radiology 0749273514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Lake Health Hospital, Concord, OH, CCN 360098
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041
  • Uh Regional Hospitals Hospital, Chardon, OH, CCN 360075
  • University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34418AZMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Apr 1, 2025 Accepting new patients
Quality Surgicenter LLC Past Accepting new patients
Heritage Emergency Physicians Past Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: afathala651318@ehrdirect.uhhospitals.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184604696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 LINCOLN WAY",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327201",
            "telephone_number": "563-242-3208",
            "fax_number": "563-242-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 LINCOLN WAY",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327201",
            "telephone_number": "563-242-3208",
            "fax_number": "563-242-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATHALA",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "34418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448019",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

Verify at the official NPI Registry.