Fathallah Hayek, MD

Key facts

NPI

1689634727

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

35-053400 (OH)

Practice address

6270 N Ridge Rd
Madison, OH 44057-2567

Phone

(440) 428-6800

Fax

(440) 255-3637

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

Organizations & group practices 12

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.

• Lake Hospital System Inc Family Medicine Physician · Middlefield, OH · NPI 1952339996
  Medicare reassignment NPD FAMILY MEDICINE · OH
• University Hospitals Medical Group Inc Multi-Specialty Clinic/Center · Cleveland, OH · NPI 1669499414
  Medicare reassignment NPD EMERGENCY MEDICINE · OH
• University Primary Care Practices Inc Gastroenterology Physician · Mentor, OH · NPI 1003935339
  Medicare reassignment NPD OH
• Lake Hospital System, Inc Urgent Care Clinic/Center · Madison, OH · NPI 1134189376
  NPD FAMILY MEDICINE
• Lake Hospital System, Inc Urgent Care Clinic/Center · Chardon, OH · NPI 1689634966
  NPD FAMILY MEDICINE
• University Primary Care Practices Inc Internal Medicine Physician · Shaker Heights, OH · NPI 1720220098
  NPD FAMILY MEDICINE
• University Primary Care Practices Inc Orthopaedic Surgery Physician · Oberlin, OH · NPI 1982727087
  NPD
• Erie Banks Emergency Physicians LLC Emergency Medicine Physician · Willoughby, OH · NPI 1801105366
  NPD (past) EMERGENCY MEDICINE
• Lake Hospital System Obstetrics & Gynecology Physician · Willoughby, OH · NPI 1346202512
  NPD (past)
• Lake Hospital System Inc Physician Assistant · Concord TWP, OH · NPI 1851698435
  NPD (past)
• Lake Hospital System Inc. Adult Health Nurse Practitioner · Concord TWP, OH · NPI 1043275837
  NPD (past)
• Lake Hospital System Inc. Urgent Care Clinic/Center · Willowick, OH · NPI 1912967209
  NPD (past) FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fhayek37113@ehrdirect.uhhospitals.org

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 6, 2021.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1689634727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE # MSO",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-953-6082",
            "fax_number": "440-953-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 N RIDGE RD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572567",
            "telephone_number": "440-428-6800",
            "fax_number": "440-255-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYEK",
        "first_name": "FATHALLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-053400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-053400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "264200002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000339404",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0623043",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "264200002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H059041",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "341425870040",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6600162",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "80507",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.f.hayek@lakehealth.org",
            "affiliation": "N",
            "endpointDescription": "Lake Health Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MADISON",
            "address_1": "8655 Market St Ste 140",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440604112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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