Michael Fattouh, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Bronx, New York. His current practice location is
111 E 210th St, Bronx, New York. You can reach out to his office (for appointments etc.) via phone at
(718) 920-2057.
Michael Fattouh is licensed to practice in New York (license number ) 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 1285139089.
Physician's Profile
Full Name | Michael Fattouh |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 111 E 210th St, Bronx, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1285139089
- Provider Enumeration Date: 03/26/2018
- Last Update Date: 06/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 3375892649
- Enrollment ID: I20240911003750
Medical Identifiers
Medical identifiers for Michael Fattouh such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1285139089 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 275907 (Massachusetts) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (New York) | 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. Michael Fattouh allows following entities to bill medicare on his behalf.
Entity Name | Montefiore Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1063525152 PECOS PAC ID: 3779496021 Enrollment ID: O20031113000235 |
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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. Michael Fattouh 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 |
Michael Fattouh, MD 111 E 210th St, Bronx, NY 10467-2401 Ph: (718) 920-2057 | Michael Fattouh, MD 111 E 210th St, Bronx, NY 10467-2401 Ph: (718) 920-2057 |
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