Emad Kamal Abdel-fattah, MD is a medicare enrolled "Pediatrics" physician in Union City, Tennessee. His current practice location is
1109 E Reelfoot Ave, Suite D, Union City, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(731) 884-2140.
Emad Kamal Abdel-fattah is licensed to practice in Tennessee (license number 35820) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164430872.
Physician's Profile
| Full Name | Emad Kamal Abdel-fattah |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 1109 E Reelfoot Ave, Union City, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164430872
- Provider Enumeration Date: 08/04/2006
- Last Update Date: 06/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294085528
- Enrollment ID: I20210222002136
Medical Identifiers
Medical identifiers for Emad Kamal Abdel-fattah such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164430872 | NPI | - | NPPES |
| 4023312 | Other | TN | BLUE CROSS BLUE SHIELD |
| 3899537 | Medicaid | TN | |
| 22089 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 35820 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Emad Kamal Abdel-fattah allows following entities to bill medicare on his behalf.
| Entity Name | Providence Medical Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285890624
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Emad Kamal Abdel-fattah is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Emad Kamal Abdel-fattah, MD
1109 E Reelfoot Ave, Suite D,
Union City, TN 38261-5856
Ph: (731) 884-2140 | Emad Kamal Abdel-fattah, MD
1109 E Reelfoot Ave, Suite D,
Union City, TN 38261-5856
Ph: (731) 884-2140 |
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