OMAR ZUHAIR ABDULFATTAH MD
NPI 1205259330
Internal Medicine - Pulmonary Disease in Springfield, IL

Q: What is Omar Abdulfattah's NPI number?

The NPI number for Omar Abdulfattah is 1205259330. It was assigned to this individual provider in the NPPES registry on January 24, 2014.

Q: What is Omar Abdulfattah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Omar Abdulfattah was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.

Active since January 24, 2014PECOS EnrolledAccepts Medicare Assignment

71.42/100

CMS Quality Rating

751 N RUTLEDGE ST STE 1700, SPRINGFIELD, IL 62702(217) 545-8000(217) 545-3782 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 24, 2025, Oct 23, 2023, Feb 21, 2023 and 2 more (5 updates tracked since 2017).

On this page

About Omar Zuhair Abdulfattah Md NPPES

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

OMAR ZUHAIR ABDULFATTAH MD (NPI 1205259330) is an individual pulmonary disease provider in Springfield, Illinois, licensed in Illinois (036.153801) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1205259330

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameOMAR ZUHAIR ABDULFATTAHCredential: MD

Location Address751 N RUTLEDGE ST STE 1700Springfield, IL 62702-4968

Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000 · Fax (217) 545-2101

Phone(217) 545-8000

Fax(217) 545-3782

Sole ProprietorYes

Medical School CMSOtherGraduated 1998

Enumeration DateJanuary 24, 2014

Last NPPES UpdateNovember 24, 20255 updates tracked since enumeration

NPPES CertifiedNovember 24, 2025

✔ NPI 1205259330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in IL · 036.153801

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 036.153801 (IL)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 036.153801 (IL)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 036.153801 (IL)

751 N RUTLEDGE ST STE 1700, Springfield, IL 62702

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Secondary Practice Locations 4

Location 12 Memorial Dr Fl 1Decatur, IL 62526-3950 · Phone (217) 872-2930 · Fax (217) 872-2979

Location 220733 N Broad StCarlinville, IL 62626-3710 · Phone (217) 545-8000 · Fax (217) 854-6462

Location 3751 N Rutledge St Ste 1100Springfield, IL 62702-4968 · Phone (217) 545-8000 · Fax (217) 545-4735

Location 4520 N 4th StSpringfield, IL 62702-5238 · Phone (217) 545-8000 · Fax (217) 757-8161

Other Identifiers 1

Medicaid036153801IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Omar Zuhair Abdulfattah Md 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 ID1759701675

PECOS Enrollment IDI20201015000033

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.

Medicare Billing Reassignments

Medicare enrollment records show Omar Abdulfattah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Siu Physicians & Surgeons, Inc

0.4 mi

Endocrinology, Diabetes & Metabolism

201 E MADISON ST STE 328
Springfield, IL 62702

Reassigned Medicare billing, Illinois enrollment
645 clinicians in this Medicare group

NPI 1558385989 (217) 545-8000

Board Of Trustees Of Southern Illinois University

0.9 mi

Primary Care

520 N 4TH ST
Springfield, IL 62702

Reassigned Medicare billing, Illinois enrollment
262 clinicians in this Medicare group

NPI 1396097960 (217) 757-8100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

229 services111 patients

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.

132 services100 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.

81 services67 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

79 services40 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

76 services61 patients

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

58 services57 patients

Sleep study including heart rate, breathing, airflow, and effort 95806

A sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.

55 services55 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

51 services35 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

49 services48 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

44 services43 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.

39 services39 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

33 services32 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

31 services31 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

27 services25 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

18 services18 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

13 services13 patients

Test to determine lung volumes using sensors 94726

12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Johns Hospital

Acute Care Hospitals · Springfield, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140053

Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County

Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140148

Location701 N First StSpringfield, IL 62702 · Sangamon County

Emergency services Birthing friendly

Pana Community Hospital

Critical Access Hospitals · Pana, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141341

Location101 E Ninth StreetPana, IL 62557 · Christian County

Emergency services

Carlinville Area Hospital

Critical Access Hospitals · Carlinville, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141347

Location20733 N Broad StreetCarlinville, IL 62626 · Macoupin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

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.

71.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

75.4

Improvement Activities

Cost

18.59

Reported Quality Measures

Colorectal Cancer Screening

49%393 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

62%37 patients3/55-star benchmark: 98%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

44%59 patients3/55-star benchmark: 98%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

33%609 patients2/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 69% · 381 patients

Patients screened: 69% · 382 patients

75%76 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

79%136 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 136 patients

Patients totalRate: 0% · 136 patients

0%136 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.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers12 claims12 services$39.50 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

5 suppliers11 claims54 services$2.21 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers27 claims28 services$19.43 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

4 suppliers14 claims15 services$118.28 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

3 suppliers27 claims28 services$15.73 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

4 suppliers26 claims27 services$45.59 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LINDA PONCE ROSAS MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)