Individual provider Active NPI

Abdullah A Fayyad, MD

  • Gastroenterology Physician
  • Elkhorn, WI
National Provider Identifier
1568466019
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35432 Issued in IA
Practice address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone
(262) 741-2000
NPI assigned
Jun 10, 2005
Last updated
Jul 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35432 IA Primary

Addresses

Primary practice location

W3985 County Road NN
Elkhorn, WI 53121-4337

Mailing address

W3985 County Road NN
Elkhorn, WI 53121-4337
Phone (262) 741-2000

Other identifiers 1

IdentifierTypeStateIssuer
0447086MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20121204000205 WI Practitioner - Gastroenterology 4789645821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

788 N Jefferson St
Suite 401
Milwaukee, WI 53202-3718
Phone (414) 226-4020

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Upper gastrointestinal (GI) endoscopy for acid reflux47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Aug 15, 2023 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Aug 15, 2023 Accepting new patients
Madison Medical Affiliates, Inc. CurrentSince May 9, 2022 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Fox Valley Pulmonary Medicine, S.C. PastSince Mar 1, 2021 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Past Accepting new patients

Locations

7423 Solutions Ctr
Chicago, IL 60677

2350 N Lake Dr
Ste 306
Milwaukee, WI 53211
Phone (414) 298-7106

788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 1

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1568466019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYYAD",
        "first_name": "ABDULLAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "35432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0447086",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.