Individual provider Active NPI

Fayrouz Ali Hachicho

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1972484517
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
LT001075 Issued in PA
Practice address
111 S 11TH St
Philadelphia, PA 19107-4870
Phone
(215) 955-6000
Fax
(215) 955-6000
NPI assigned
Sep 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X LT001075 PA Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4870

Mailing address

1500 Locust St Apt 3214
Philadelphia, PA 19102-4321
Phone (215) 955-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251002000810 PA Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 8325544992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1972484517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST APT 3214",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024321",
            "telephone_number": "215-955-6000",
            "fax_number": "215-955-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074870",
            "telephone_number": "215-955-6000",
            "fax_number": "215-955-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACHICHO",
        "first_name": "FAYROUZ",
        "middle_name": "ALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "LT001075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.