Abdulfatah Adnan Barakat, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95028714 Issued in CA

Practice address

2103 Pickwick Dr
Camarillo, CA 93010-6427

Phone

(805) 484-7448

Fax

(805) 484-3642

NPI assigned

Apr 9, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642

  CA

  Medicare reassignment NPD
• Morin Medical Corp.

  • Internal Medicine Physician
  • Camarillo, CA
  • NPI 1215121413
  NPD

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1598518482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 PICKWICK DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106427",
            "telephone_number": "805-484-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 PICKWICK DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106427",
            "telephone_number": "805-484-7448",
            "fax_number": "805-484-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKAT",
        "first_name": "ABDULFATAH",
        "middle_name": "ADNAN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Ballard
• Jody Lynn Balloch, MD
• Genesis Alexa Banda-Donato, RBT
• Derrick Deshawn Banks
• Karina Banuelos
• Sabrina Carvalho Barata, MD
• Melissa Erin Barber, M.S. CCC-A
• Tom Barber III
• Jennifer Louise Barbettini
• Savannah Eden Greyrose Baril, MD, MSC

• All providers in Camarillo, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.