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DR. ABDULFATAH M ALI M.D.
NPI 1053382937
Ophthalmology in Plano, TX

Active since January 30, 2006PECOS EnrolledAccepts Medicare Assignment
77.35/100
CMS Quality Rating
4108 WEST 15TH ST., SUITE 200, PLANO, TX 75075(972) 379-3937(972) 379-3938 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Abdulfatah M Ali M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ABDULFATAH M ALI M.D. (NPI 1053382937) is an individual ophthalmology provider in Plano, Texas, licensed in Texas (P0532) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Wisconsin (1997).

NPPES Registry Identity

NPI1053382937
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. ABDULFATAH M ALICredential: M.D.
Location Address4108 WEST 15TH ST., SUITE 200Plano, TX 75075-5841
Mailing Address4108 West 15th St., Suite 200Plano, TX 75075-5841 · (972) 379-3937 · Fax (972) 379-3938
Phone(972) 379-3937
Fax(972) 379-3938
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 1997
Enumeration DateJanuary 30, 2006
Last NPPES UpdateJuly 18, 2016
✔ NPI 1053382937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in TX · P0532✔ Licensed in CO · DR43898
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
4108 WEST 15TH ST., Plano, TX 75075
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Other Identifiers 3

Medicaid84833378CO
Medicare PINCO300510CO
Medicare UPINH50532CO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Abdulfatah M Ali M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274588389
PECOS Enrollment IDI20111117000467
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
241 services118 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
126 services80 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
114 services112 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
100 services69 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
76 services45 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
59 services59 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality84.63
Improvement Activities40
Cost45

Reported Quality Measures

Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
95%109 patients3/55-star benchmark: 100%
Complications After Cataract Surgery
Lower rates are better for this measure.
2%215 patients
Diabetes: Eye Exam
87%160 patients4/55-star benchmark: 100%
Glaucoma Intraocular Pressure Reduction
85%195 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 784 patients
Patients totalRate: 0% · 784 patients
0%784 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Abdulfatah Ali's NPI number?

The NPI number for Abdulfatah Ali is 1053382937. It was assigned to this individual provider in the NPPES registry on January 30, 2006.

Where is Abdulfatah Ali located?

Abdulfatah Ali practices at 4108 West 15th St. Suite 200, Plano, TX 75075. The listed phone number is (972) 379-3937.

What is Abdulfatah Ali's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Abdulfatah Ali enrolled in Medicare?

Yes. Abdulfatah Ali is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Abdulfatah Ali accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Abdulfatah Ali as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Abdulfatah Ali was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.