BASIL M FATHALLA M.D.
NPI 1205879954
Pediatrics - Pediatric Rheumatology in Detroit, MI

Active since June 13, 2006PECOS EnrolledAccepts Medicare Assignment
3901 BEAUBIEN ST, CHILDREN'S HOSPITAL OF MI, DETROIT, MI 48201(215) 427-5094 Get Directions Write a Review

NPPES record last updated: May 28, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Basil M Fathalla M.d. NPPES

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

BASIL M FATHALLA M.D. (NPI 1205879954) is an individual pediatric rheumatology provider in Detroit, Michigan, licensed in Pennsylvania (MD427787) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1205879954
Entity TypeIndividualMale
Primary Taxonomy2080P0216X
Provider Legal NameBASIL M FATHALLACredential: M.D.
Location Address3901 BEAUBIEN ST, CHILDREN'S HOSPITAL OF MIDetroit, MI 48201-2119
Mailing Address4201 St. Antoine, University Pediatricians Uhc 6f Mailbox# 226Detroit, MI 48201-4139 · (313) 966-5051
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateJune 13, 2006
Last NPPES UpdateMay 28, 2009
NPI 1205879954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Pediatric RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0216X
License Licensed in PA · MD427787
Definition
A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
3901 BEAUBIEN ST, Detroit, MI 48201

Other Identifiers 3

Medicaid1014672880001PA
Medicare ID-Type Unspecified097803
Medicare UPING93282

Accepted 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

Basil M Fathalla 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 ID2264446905
PECOS Enrollment IDI20090130000206
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.

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.

Pediatrics (Pediatric Emergency Medicine)
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Physician Assistant (Surgical)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201

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 Basil Fathalla's NPI number?

The NPI number for Basil Fathalla is 1205879954. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Where is Basil Fathalla located?

Basil Fathalla practices at 3901 Beaubien St Children's Hospital Of Mi, Detroit, MI 48201. The listed phone number is (215) 427-5094.

What is Basil Fathalla's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Rheumatology, with taxonomy code 2080P0216X.

Is Basil Fathalla enrolled in Medicare?

Yes. Basil Fathalla 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 Basil Fathalla accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Basil Fathalla 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 Basil Fathalla was last updated on May 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.