Individual provider Active NPI

Fares Sukhon, MD

  • Interventional Cardiology Physician
  • Wynnewood, PA
National Provider Identifier
1962011833
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD-55482 Issued in IA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone
(484) 476-2000
NPI assigned
Jul 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X MT220855 PA
Interventional Cardiology Physician 207RI0011X MD-55482 IA Primary
Cardiovascular Disease Physician 207RC0000X MD-55482 IA

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Mailing address

1236 E Rusholme St Ste 300
Davenport, IA 52803-2484
Phone (563) 324-2992

Other practice location 1

1236 E Rusholme St Ste 300
Davenport, IA 52803-2484
Phone (563) 324-2992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20260513001908 IA Practitioner - Interventional Cardiology 1850717703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1236 E Rusholme St
Suite 300
Davenport, IA 52803-2473

1351 W Central Park Ave
Suite 4100
Davenport, IA 52804-1847

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: fsukhon222335@direct.metrohealth.org
  • Direct secure messaging: fsukhon1084136@direct.hfhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1962011833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST STE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032484",
            "telephone_number": "563-324-2992",
            "fax_number": "563-324-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1236 E Rusholme St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528032484",
            "country_code": "US",
            "telephone_number": "563-324-2992",
            "fax_number": "563-324-8562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUKHON",
        "first_name": "FARES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT220855",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IA",
            "license": "MD-55482",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "MD-55482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.