Active NPI
Leo Matthew Fatur, M.D.
- Internal Medicine Physician
- Bridgeville, PA
National Provider Identifier
1316933716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD19424E
- Practice address
- 424 Shady Ave
Bridgeville, PA 15017-1962 - Phone
- (412) 221-1900
- Fax
- (412) 257-1840
- NPI assigned
- Sep 21, 2005
- Reactivated
- Dec 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD19424E | PA | Primary |
Addresses
Primary practice location
424 Shady Ave
Bridgeville, PA 15017-1962
Mailing address
424 Shady Ave
Bridgeville, PA 15017-1962
Phone (412) 221-1900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150220000039 | PA | Order and Referring Only - Internal Medicine | 6608191309 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19424E | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291852800000",
"number": "1316933716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 SHADY AVE",
"city": "BRIDGEVILLE",
"state": "PA",
"postal_code": "150171962",
"telephone_number": "412-221-1900",
"fax_number": "412-257-1840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 SHADY AVE",
"city": "BRIDGEVILLE",
"state": "PA",
"postal_code": "150171962",
"telephone_number": "412-221-1900",
"fax_number": "412-257-1840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATUR",
"first_name": "LEO",
"middle_name": "MATTHEW",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2010-12-09",
"deactivation_date": "2010-02-09",
"reactivation_date": "2010-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD19424E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.