NPIMap

Individual provider Active NPI

Kahtan N Fadah, D.O.

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1689297723
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
W1162 Issued in TX
Practice address
601 Elmwood Avenue
#679
Rochester, NY 14642
Phone
(585) 275-4290
Fax
(585) 473-1573
NPI assigned
May 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X W1162 TX Primary

Addresses

Primary practice location

601 Elmwood Avenue
#679
Rochester, NY 14642

Mailing address

601 Elmwood Avenue
Box 679
Rochester, NY 14642
Phone (585) 275-4290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260224001418 TX Practitioner - Internal Medicine 1456832807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunset Heights Physician Services PAGroup PAC ID 9830683705, 61 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr Dr
El Paso, TX 79902-5005
Phone (915) 747-4000

3280 Joe Battle Blvd
El Paso, TX 79938-2622
Phone (915) 832-2000

Hospital & facility affiliations

  • The Hospitals of Providence - East Campus Hospital, El Paso, TX, CCN 670047
  • Sierra Medical Center Hospital, El Paso, TX, CCN 450668
  • The Hospitals of Providence Horizon City Campus Hospital, Horizon City, TX, CCN 670124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
W1162TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jan 27, 2026 Accepting new patients
Sunset Heights Physician Services PA Internal Medicine CurrentSince Dec 28, 2025 Accepting new patients
Cardiology Clinical Group Past Accepting new patients
Tenet Hospitals Limited Past Accepting new patients

Locations

3280 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 577-6000

2601 Dimmitt Rd
Plainview, TX 79072
Phone (806) 296-4282

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1590192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1689297723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE",
            "address_2": "BOX 679",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-275-4290",
            "fax_number": "585-473-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE",
            "address_2": "#679",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-275-4290",
            "fax_number": "585-473-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAH",
        "first_name": "KAHTAN",
        "middle_name": "N",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-23",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "W1162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.