NPIMap

Individual provider Active NPI

Fadi Elia Rahhal, MD

  • Gastroenterology Physician
  • Clermont, FL
National Provider Identifier
1306062724
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME 121905 Issued in FL
Practice address
821 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone
(352) 242-1665
Fax
(352) 243-1649
NPI assigned
Apr 17, 2007
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME 121905 FL Primary
General Practice Physician 208D00000X 058493 GA

Addresses

Primary practice location

821 Oakley Seaver Dr
Clermont, FL 34711-1968

Mailing address

2040 Oakley Seaver Dr
Clermont, FL 34711-1962
Phone (352) 242-1665

Other identifiers 1

IdentifierTypeStateIssuer
019683900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20141204002213 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 6709939473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Lake Gastroenterology IncGroup PAC ID 9436168796, 5 clinicians

Practice addresses (Care Compare)

2040 Oakley Seaver Dr
Clermont, FL 34711-1962
Phone (352) 242-1665

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.01 of 100Reported as group
Quality
80.12
Promoting interoperability
95
Improvement activities
40
Cost
72.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy250
Upper gastrointestinal (GI) endoscopy for acid reflux316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 121905FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Lake Gastroenterology Inc CurrentSince Nov 17, 2014 Accepting new patients

Locations

2040 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 242-1665

821 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 242-1665

2302 North Blvd W
Davenport, FL 33837

201 Mohawk Rd
Ste 100
Minneola, FL 34715

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJABCA

Organizations & group practices 1

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 6

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1306062724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111962",
            "telephone_number": "352-242-1665",
            "fax_number": "352-243-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-242-1665",
            "fax_number": "352-243-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHHAL",
        "first_name": "FADI",
        "middle_name": "ELIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME 121905",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "058493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019683900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.