Active NPI
Thaer Saqer Mustafa Abdelfattah, M.D.
- Gastroenterology Physician
- Birmingham, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 52886
- Practice address
- 619 19TH St S
Birmingham, AL 35233-1900 - Phone
- (205) 934-4011
- NPI assigned
- Aug 31, 2016
- Reactivated
- Jun 27, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD19125 | RI | |
| Gastroenterology Physician | 207RG0100X | 52886 | AL | Primary |
| Internal Medicine Physician | 207R00000X | 57027521 | OH |
Addresses
Primary practice location
619 19TH St S
Birmingham, AL 35233-1900
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Other practice location 1
825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-6510
Other practice location 2
50 Maude St
Providence, RI 02908-4325
Phone (401) 456-6510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI, AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711001088 | RI | Practitioner - Gastroenterology | 2163757238 | Reassigns benefits to 2 organizations |
| I20260623001866 | AL | Practitioner - Gastroenterology | 2163757238 |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Prospect Chartercare Physicians LLCUniversity of Alabama Health Services Foundation, PC
Practice addresses (Care Compare)
1 Office Pkwy
East Providence, RI 02914-1643
Phone (401) 431-9219
619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011
Hospital & facility affiliations
- Roger Williams Medical Center
- Our Lady of Fatima Hospital
- The Miriam Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 62 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 96 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57027521 | OH | MD | Internal Medicine Physician |
| MD19125 | RI | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prospect Chartercare Physicians, LLC | Internal Medicine | Current | Accepting new patients |
| Chartercare Physicians, LLC | Internal Medicine | Current | Accepting new patients |
| Prospect Chartercare Elmhurst, LLC | Past | Accepting new patients |
Locations
1681 Cranston St
Cranston, RI 02920
Phone (401) 944-6889
1 Office Pkwy
East Providence, RI 02914
Phone (401) 270-7110
50 Maude St
Providence, RI 02908
Phone (401) 456-2200
50 Maude St
Ste 3
Providence, RI 02908
825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000
50 Maude St
#3
Providence, RI 02908
501 Wampanoag Trl
Unit 2
Riverside, RI 02915
Phone (401) 435-3327
Interoperability endpoints
- thaer.abdelfattah.1@9000.direct.athenahealth.com
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1629493135
Internal Medicine, RI
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1235945650
Internal Medicine, RI
-
- Oral and Maxillofacial Surgery (Dentist)
- Birmingham, AL
- NPI 1720761554
-
- Clinical Medical Laboratory
- Birmingham, AL
- NPI 1366638330
-
- Prosthetic/Orthotic Supplier
- Birmingham, AL
- NPI 1841380086
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
- Skilled Nursing Facility
- Providence, RI
- NPI 1457776452
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- North Providence, RI
- NPI 1871918870
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1346796091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331900",
"telephone_number": "205-934-4011"
}
],
"practiceLocations": [
{
"address_1": "825 Chalkstone Ave",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029084728",
"country_code": "US",
"telephone_number": "401-456-6510",
"fax_number": "401-456-6852",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "50 Maude St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029084325",
"country_code": "US",
"telephone_number": "401-456-6510",
"fax_number": "401-456-6852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDELFATTAH",
"first_name": "THAER",
"middle_name": "SAQER MUSTAFA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-31",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"deactivation_date": "2019-06-19",
"reactivation_date": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "RI",
"license": "MD19125",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "AL",
"license": "52886",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "57027521",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.