Roa Fathi Al-Abdalla, OD, MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV008870 Issued in NY

Practice address

714 W 181St St
New York, NY 10033-4702

Phone

(212) 517-0999

NPI assigned

Aug 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sajid Malik, MD PCGroup PAC ID 6103955265, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Sajid Malik MD PC

  • Ophthalmology Physician
  • Hicksville, NY
  • NPI 1215161047

  Optometrist

  Medicare reassignment Care Compare group NPD
• Vip Eye Care Optometry P.C.

  • Optometrist
  • New York, NY
  • NPI 1699117689
  Medicare reassignment NPD
• Vision Quest of Bruckner Corp.

  • Eyewear Supplier
  • Bronx, NY
  • NPI 1003968819
  Medicare reassignment

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

{
    "created_epoch": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1730660978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 9TH ST APT 2",
            "city": "FAIRVIEW",
            "state": "NJ",
            "postal_code": "070222332",
            "telephone_number": "201-654-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W 181ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334702",
            "telephone_number": "212-517-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 9th St Apt 2",
            "address_purpose": "LOCATION",
            "city": "Fairview",
            "state": "NJ",
            "postal_code": "070221311",
            "country_code": "US",
            "telephone_number": "201-654-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-ABDALLA",
        "first_name": "ROA",
        "middle_name": "FATHI",
        "name_prefix": "Dr.",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV008870",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NY",
            "license": "TUV008870",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "TUV008870",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "TUV008870",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NY",
            "license": "TUV008870",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saad Thabet a Al Qahtani, M.D
• Duaa Hassan Al Rawi, MD PHD
• Wael Al Shuab, DO
• Reyan Al Taee
• Manar Jamal Al Turkmani, MBBS
• Nehad Emad Al-Abed, PA-C
• Anwar Al-Awadhi, M.D
• Omar Al-Dweik
• Paul Al-Fakhoury
• Yahya Al-Ghamdi, MBBS

• Optometrist in New York, NY
• Providers in New York, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.