Individual provider Active NPI

Kamal Fadlalla

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1679945380
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME136789 Issued in FL
Practice address
753 Classon Ave Apt 1C
Brooklyn, NY 11238-4614
Phone
(646) 707-6285
NPI assigned
Oct 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME136789 FL Primary

Addresses

Primary practice location

753 Classon Ave Apt 1C
Brooklyn, NY 11238-4614

Mailing address

753 Classon Ave Apt 1C
Brooklyn, NY 11238-4614
Phone (646) 707-6285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180918000821 FL Practitioner - Internal Medicine 4587915368 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Aug 6, 2018 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Aug 6, 2018 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Nov 10, 2021 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Nov 10, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

15255 Max Leggett Pkwy
Jacksonville, FL 32218
Phone (904) 383-1000

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

3100 E Fletcher Ave
#C
Tampa, FL 33613

Interoperability endpoints

  • Direct secure messaging: kfadlalla323186@orlandohealth.medalliesdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1679945380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 CLASSON AVE APT 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384614",
            "telephone_number": "646-707-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 CLASSON AVE APT 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384614",
            "telephone_number": "646-707-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADLALLA",
        "first_name": "KAMAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME136789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.