Ahmad Atallah, MD, MA
Individual provider Active NPI Internal Medicine Physician · Mesa, AZ
NPI 1689237695 · NPPES record last updated Aug 15, 2022
Key facts
- NPI
- 1689237695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 65596 (AZ)
- Practice address
- 6644 E Baywood Ave
Mesa, AZ 85206-1797 - Phone
- (480) 321-2000
- NPI assigned
- Apr 16, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Creighton University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Hospital Based Physicians Arizona LLC
Practice addresses (Care Compare)
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone (480) 321-2000
Hospital & facility affiliations
- Banner Desert Medical Center
- Banner Baywood Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.7 of 100
- Quality
- 64.97
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 69.88
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220707003666 | AZ | Practitioner - Internal Medicine |
8022344431 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65596 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Hospital Based Physicians Arizona LLC | Current |
Accepting new patients | |
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Arizona LLC | Current |
Accepting new patients | |
| Banner Heart Hospital | Past | Accepting new patients | |
| Banner Desert Medical Center | Past | Accepting new patients | |
| Banner Baywood Medical Center | Past | Accepting new patients |
Locations
1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000
1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000
6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | AZ | ||
| Internal Medicine Physician | 207R00000X | 65596 | AZ | Yes |
Addresses
Primary practice location
6644 E Baywood Ave
Mesa, AZ 85206-1797
Mailing address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2266
Other practice location 1
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2266
Other providers in Mesa, AZ
- Kimberly Aston
- Marie Noelle N Asu Takor
- At Direct Sports Medicine, LLC
- At Home Care Inc.
- At the Moment Health, LLC
- Athena in Home Care Inc
- Elizabeth Athens
- Hemanthkumar Athiraman
- Lauren Amber Atkins
- Maria Stewart Atkins
All providers in Mesa, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.