Individual provider Active NPI

Fahad Ali, MD

  • Cardiovascular Disease Physician
  • Fort Pierce, FL
National Provider Identifier
1861748345
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME145931 Issued in FL
Practice address
2000 Hartman Rd Ste 1
Fort Pierce, FL 34947-4413
Phone
(772) 402-3449
Fax
(772) 310-3811
NPI assigned
Aug 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X ME145931 FL
Cardiovascular Disease Physician 207RC0000X ME145931 FL Primary

Addresses

Primary practice location

2000 Hartman Rd Ste 1
Fort Pierce, FL 34947-4413

Mailing address

2609 S Federal Hwy # 1049
Fort Pierce, FL 34982-5923
Phone (570) 867-3025

Other identifiers 1

IdentifierTypeStateIssuer
ME145931OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200709002886 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2264718543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Suite a
Port St Lucie, FL 34952-7545
Phone (772) 402-3449

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145931FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Aug 1, 2022 Accepting new patients
Sinus Node Solutions Cardiovascular Disease CurrentSince Jan 31, 2023 Accepting new patients
Lee Memorial Health System Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
University of Maryland Physicians P.a. Past Accepting new patients

Locations

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

16261 Bass Rd
Ste 300
Fort Myers, FL 33908
Phone (239) 274-8866

2000 Hartman Rd
Ste 1
Fort Pierce, FL 34947
Phone (772) 465-1170

2609 S Federal Hwy
Fort Pierce, FL 34982

1801 SE Hillmoor Dr
Ste A
Port St Lucie, FL 34952
Phone (772) 402-3449

1001 SE Ocean Blvd
Ste 102
Stuart, FL 34996
Phone (772) 286-1606

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: fali38268@direct-guthrie.org

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 3

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": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1861748345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 S FEDERAL HWY # 1049",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825923",
            "telephone_number": "570-867-3025",
            "fax_number": "772-310-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HARTMAN RD STE 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474413",
            "telephone_number": "772-402-3449",
            "fax_number": "772-310-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "FAHAD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME145931",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME145931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME145931",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.