Individual provider Active NPI

Fatema Ali, M.D

  • Pediatric Gastroenterology Physician
  • Columbus, OH
National Provider Identifier
1508420894
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
35152799 Issued in OH
Practice address
555 S 18TH St
Columbus, OH 43205-2654
Phone
(614) 722-3450
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Gastroenterology Physician 2080P0206X 35152799 OH Primary

Addresses

Primary practice location

555 S 18TH St
Columbus, OH 43205-2654

Mailing address

555 S 18TH St
Columbus, OH 43205-2654
Phone (917) 488-8782

Other practice location 1

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5437

Other practice location 2

848 Adams Ave
Memphis, TN 38103-2816
Phone (901) 287-5437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190706000179 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9436484995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35152799OHMDPediatric Gastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1508420894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052654",
            "telephone_number": "917-488-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052654",
            "telephone_number": "614-722-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-287-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "FATEMA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "35152799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.