Siraj Healthcare Incorporated
Organization Active NPI Family Medicine Physician · Elsmere, KY
NPI 1487092334 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1487092334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SIRAJ HEALTHCARE INCORPORATED
- Practice address
- 3876 Turkeyfoot Rd
Elsmere, KY 41018-2838 - Phone
- (859) 342-4087
- NPI assigned
- Jun 12, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Mohammad Fattal, M.D.
- Title
- Owner
- Phone
- (859) 342-4087
Practitioners 6
-
Mohammad Fattal, MD
-
Tracy Meyers, FNP
-
Ashley Nicole Pope, APRN
-
Ahmad Anjak, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130814000023 | KY | Part B Supplier - Clinic/Group Practice | 4981846318 |
Receives reassigned benefits from 6 practitioners Practice locations: Fort Thomas, KY; Union, KY; Elsmere, KY; Cold Spring, KY; Erlanger, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
3876 Turkeyfoot Rd
Elsmere, KY 41018-2838
Mailing address
PO Box 6716
Florence, KY 41022-6716
Phone (859) 342-4087
Other providers in Elsmere, KY
- Robert Sandlin Jr.
- Michael A Sanford
- Schelli Hoefinghoff Schroder
- Muhammad Jamal Shah
- Lynde Shaw
- Elizabeth Smith
- Christine Sorrell
- Shannon Dawn Spurlock
- Alyssa Teague
- Jennifer Annette Thornton
All providers in Elsmere, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.