NPIMap

Individual provider Active NPI

Mohanad M Fallouh, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1619915527
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD443377 Issued in PA
Practice address
6950 Germantown Ave
Philadelphia, PA 19119-2120
Phone
(484) 443-4406
Fax
(484) 448-2203
NPI assigned
Jun 3, 2006
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 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 4301083048 MI
Internal Medicine Physician 207R00000X MD443377 PA Primary

Addresses

Primary practice location

6950 Germantown Ave
Philadelphia, PA 19119-2120

Mailing address

6950 Germantown Ave
Philadelphia, PA 19119-2114
Phone (484) 443-4406

Other identifiers 11

IdentifierTypeStateIssuer
1103710361OtherMIBCBSM
4847475-10MedicaidMI
1018503OtherMIMCLAREN HEALTH PLAN
440771OtherPAMLHC MEDICARE AA #
4732682-10MedicaidMI
01005838OtherMIHEALTHPLUS COMMERCIAL
4885019-10MedicaidMI
1020183OtherMIMCLAREN HEALTH PLAN
200000005731OtherMIPHP COMMERCIAL
440771OtherPAMLHC BCBS AA #
1016406OtherMIMCLAREN HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110822000194 PA Practitioner - Internal Medicine 3971542564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6950 Germantown Ave
Philadelphia, PA 19119-2114
Phone (215) 848-3306

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Todd D Aaron MD F a C P PC Internal Medicine CurrentSince Apr 17, 2023 Accepting new patients
Medics PC Past Accepting new patients
Germantown Home Past Accepting new patients
CHH Community Health Past Accepting new patients
Chestnut Hill Clinic Company, LLC Internal Medicine PastSince Apr 17, 2023 Accepting new patients
Main Line Healthcare Internal Medicine PastSince Jul 1, 2008 Accepting new patients

Locations

6950 Germantown Ave
Philadelphia, PA 19119
Phone (215) 261-7117

6950 Germantown Ave
#M
Philadelphia, PA 19119
Phone (215) 848-3306

8815 Germantown Ave
Ste 31
Philadelphia, PA 19118
Phone (215) 242-8155

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 8

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1619915527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192114",
            "telephone_number": "484-443-4406",
            "fax_number": "484-448-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192120",
            "telephone_number": "484-443-4406",
            "fax_number": "484-448-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLOUH",
        "first_name": "MOHANAD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301083048",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1103710361",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4847475-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1018503",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MLHC MEDICARE AA #",
            "identifier": "440771",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4732682-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS COMMERCIAL",
            "identifier": "01005838",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4885019-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1020183",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP COMMERCIAL",
            "identifier": "200000005731",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MLHC BCBS AA #",
            "identifier": "440771",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1016406",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.