Individual provider Active NPI

Abdulfatah Abdul Issak, MD

  • Gastroenterology Physician
  • Columbus, OH
National Provider Identifier
1720406325
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
35129731 Issued in OH
Practice address
3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone
(614) 754-5500
Fax
(614) 754-5501
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35129731 OH Primary
Internal Medicine Physician 207R00000X 129731 OH
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3400 Olentangy River Rd
Columbus, OH 43202-1523

Mailing address

3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone (614) 754-5500

Other practice location 1

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Other practice location 2

3595 Olentangy River Rd
Columbus, OH 43214-3440
Phone (614) 566-5456

Other practice location 3

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

Other practice location 4

7700 Washington Village Dr Ste 120
Centerville, OH 45459-4071
Phone (937) 425-4144

Other identifiers 1

IdentifierTypeStateIssuer
0218537MedicaidOH

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address aissak565235@direct.ketteringhealth.org
Direct Messaging Address aissak933646@direct.ohiohealth.com OhioHealth Physician Group, Inc.
Direct Messaging Address ohio.gastro@directaddress.net Direct
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170515001033 OH Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Hospitalist 1254551617 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.34 of 100Reported as group
Quality
59.66
Promoting interoperability
99
Improvement activities
40
Cost
68.99

Merit-based Incentive Payment System (MIPS)

Final score
96.78 of 100Reported as apm
Quality
89.46
Promoting interoperability
99.02
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129731OHMDInternal Medicine Physician
35129731OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Aug 1, 2023 Accepting new patients
Ohiohealth Corporation Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Sep 5, 2024 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Aug 16, 2024 Accepting new patients

Locations

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Dept L3652
Columbus, OH 43260

3595 Olentangy River Rd
Columbus, OH 43214
Phone (614) 556-5456

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

7700 Washington Village Dr
Ste 120
Dayton, OH 45459
Phone (937) 425-4144

7700 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (937) 531-0195

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

Organizations & group practices 5

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 5

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1720406325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3595 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143440",
            "country_code": "US",
            "telephone_number": "614-566-5456",
            "fax_number": "614-566-6902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-672-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7700 Washington Village Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594071",
            "country_code": "US",
            "telephone_number": "937-425-4144",
            "fax_number": "937-425-4146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSAK",
        "first_name": "ABDULFATAH",
        "middle_name": "ABDUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35129731",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "129731",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0218537",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aissak565235@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "7700 Washington Village Dr Ste 120",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aissak933646@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "3595 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohio.gastro@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432021523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "7700 Washington Village Dr Ste 120",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.