Fala Medical Clinic PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FALA MEDICAL CLINIC PLLC

Practice address

14749 W Mountain View Blvd Ste 138
Surprise, AZ 85374-2704

Phone

(623) 738-0440

Fax

(480) 374-8051

NPI assigned

Jan 28, 2020

Last updated

May 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Freschta Mirzakhel

Title

Practice Adminisitrator

Phone

(480) 258-8264

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hamidullah Habib Fala, MD

  • Internal Medicine Physician
  • Surprise, AZ
  • NPI 1124284625

  Single Specialty

  Medicare reassignment NPD
• Bridget Mackie, FNP

  • Family Nurse Practitioner
  • Fort Huachuca, AZ
  • NPI 1023570207
  Medicare reassignment NPD

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1972134054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14749 W MOUNTAIN VIEW BLVD STE 138",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-738-0440",
            "fax_number": "480-374-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14749 W MOUNTAIN VIEW BLVD STE 138",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-738-0440",
            "fax_number": "480-374-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALA MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "MIRZAKHEL",
        "authorized_official_first_name": "FRESCHTA",
        "authorized_official_title_or_position": "PRACTICE  ADMINISITRATOR",
        "authorized_official_telephone_number": "480-258-8264"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546663",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawn Faber, FNP
• Rosemary Fadool, DO
• Sarah Fagus
• Jeffrey Fairer
• Faith N Grace Transport LLC
• Hamidullah Habib Fala, MD
• Family Care Connections LLC
• Family Telemed PLLC
• Family Urgent Care PLLC
• King Fanene, RBT

• Primary Care Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.