Michael H. Fattal, M.D,

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

246526 Issued in MA

Practice address

54 Baker Avenue Ext
Suite 303
Concord, MA 01742-2137

Phone

(978) 369-8780

Fax

(978) 369-1043

NPI assigned

Dec 12, 2007

Last updated

Jul 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Otolaryngology

Education

State University of Ny Upstate Medical University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massachusetts Eye and Ear Associates, IncGroup PAC ID 4486540275, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emerson Hospital - Hospital, W Concord, MA, CCN 220084
• Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fattal.michael.meei@direct.partners.masshiway.net

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.

• Massachusetts Eye and Ear Associates, Inc.

  • Ophthalmology Physician
  • Boston, MA
  • NPI 1932574332
  Medicare reassignment Care Compare group
• Massachusetts Eye and Ear Infirmary

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1639101751
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1922103357
  Care Compare affiliation
• Massachusetts Eye and Ear Infirmary

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1639101751
  Care Compare affiliation

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1679756704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BAKER AVENUE EXT",
            "address_2": "SUITE 303",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422137",
            "telephone_number": "978-369-8780",
            "fax_number": "978-369-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 BAKER AVENUE EXT",
            "address_2": "SUITE 303",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422137",
            "telephone_number": "978-369-8780",
            "fax_number": "978-369-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTAL",
        "first_name": "MICHAEL",
        "middle_name": "H.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "246526",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MA",
            "license": "246526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110089465A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Familywell PLLC
• Karen Marie Fanucci, MD
• Ellen Farmer, RN
• Philip Farrelly
• Allyson Morgan Farren, MS, OTR/L
• Elizabeth Faure Peguero
• Michelle Kraynack Faux, M.A.
• Jane H Fay, M.D.
• Edward J Federman, PH.D.
• Jessica Marie Fedorowicz

• Facial Plastic Surgery Physician in Concord, MA
• Providers in Concord, MA by specialty
• Facial Plastic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.