Individual provider Active NPI

Katayoun Fomani, MD

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1578995320
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46110 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249-1900
Phone
(205) 934-4011
NPI assigned
Aug 4, 2013
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 271018 NY
Internal Medicine Physician 207R00000X 46110 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249-1900

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Other practice location 1

27005 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131219000018 NY Practitioner - PathologyPractitioner - Internal Medicine 3274760244 Reassigns benefits to 3 organizations
I20230412002210 AL Practitioner - Pathology 3274760244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 23, 2014 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Oct 10, 2013 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 1, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Oct 10, 2013 Accepting new patients
Nassau Health Care Corporation CurrentSince Jul 14, 2015 Accepting new patients
Nassau Health Care Corporation CurrentSince Jul 14, 2015 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients

Locations

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

111 E 210th St
Bronx, NY 10467

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

27005 76th Ave
North New Hyde Pk, NY 11040

Interoperability endpoints

  • Direct secure messaging: katayounfomani@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: kfomani@direct.uabmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1375574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1578995320",
    "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",
            "telephone_number": "205-731-9701"
        },
        {
            "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": "352491900",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "11040",
            "country_code": "US",
            "telephone_number": "718-470-5144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOMANI",
        "first_name": "KATAYOUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-04",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "271018",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "46110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.