Hithem Ahmed Atia Fargaly, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

16388A Issued in WY

Practice address

4201 St.Antoine
Uhc 9C
Detroit, MI 48201

Phone

(313) 745-5147

NPI assigned

Apr 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Neurology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Health Physicians West LLCGroup PAC ID 5092978866, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usrc Wyoming Kidney Dialysis facility, Casper, WY, CCN 532504
• Banner Wyoming Medical Center Hospital, Casper, WY, CCN 530012
• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302
• Sagewest Health Care Hospital, Riverton, WY, CCN 530008
• Memorial Hospital of Carbon County Hospital, Rawlins, WY, CCN 531316

Merit-based Incentive Payment System (MIPS)

Final score

80.9 of 100Reported as group

Quality

68.13

Promoting interoperability

99

Improvement activities

40

Cost

69.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Casper, WY
  • NPI 1063778728
  Medicare reassignment Care Compare group NPD
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wyoming Kidney Center, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Casper, WY
  • NPI 1508837865

  Dialysis facility

  Care Compare affiliation Name & address match
• Memorial Hospital of Carbon County

  • Critical Access Hospital
  • Rawlins, WY
  • NPI 1710298757
  Care Compare affiliation
• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Care Compare affiliation
• Riverton Memorial Hospital LLC

  • Rural Acute Care Hospital
  • Lander, WY
  • NPI 1245337286
  Care Compare affiliation
• Wyoming Medical Center Inc

  • General Acute Care Hospital
  • Casper, WY
  • NPI 1346332954
  Care Compare affiliation

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1932763802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8756 TOWN AND COUNTRY BLVD APT F",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433048",
            "telephone_number": "302-670-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST.ANTOINE",
            "address_2": "UHC 9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARGALY",
        "first_name": "HITHEM",
        "middle_name": "AHMED ATIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WY",
            "license": "16388A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamad Fardous
• Toufic Fardous
• Areej Musa Fares, MSBS, PA-C
• Sobhi Fares, M.D.
• Imadeddine Farfour, MD
• Peter Fargo
• Hana'a Saed Farha, M.A. CF-SLP
• Shatha Younis Mustafa Farhan, MD
• Ashley Taylor Farhat-Tomaszewski, FNP-BC
• Belinda Hernandez Farhat, RN

• Nephrology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.