DR. JACK FATIHA M.D.
NPI 1619969177
Family Medicine in Brooklyn, NY

Q: What is Jack Fatiha's NPI number?

The NPI number for Jack Fatiha is 1619969177. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Q: What is Jack Fatiha's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Fatiha was last updated on April 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since August 19, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 33D1066806 · Waiver

709 AVENUE U, BROOKLYN, NY 11223(718) 336-0100(718) 336-7139 Get Directions Write a Review

NPPES record last updated: April 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Jack Fatiha M.d. NPPES

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

DR. JACK FATIHA M.D. (NPI 1619969177) is an individual family medicine provider in Brooklyn, New York, licensed in New York (229099) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 2, 2027, and is affiliated with Maimonides Medical Center.

NPPES Registry Identity

NPI1619969177

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JACK FATIHACredential: M.D.

Location Address709 AVENUE UBrooklyn, NY 11223-4133

Mailing Address709 Avenue UBrooklyn, NY 11223-4133 · (718) 336-0100 · Fax (718) 336-7139

Phone(718) 336-0100

Fax(718) 336-7139

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateAugust 19, 2005

Last NPPES UpdateApril 11, 2008

✔ NPI 1619969177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 229099

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

709 AVENUE U, Brooklyn, NY 11223

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Other Identifiers 3

Medicare PIN0377P1NY

Medicaid02495889NY

Medicare UPINI01010NY

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. Jack Fatiha 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 ID1153314612

PECOS Enrollment IDI20040408000522

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1066806

Jack Fatiha MD · Brooklyn, NY

Active · expires Apr 2, 2027

CLIA Number33D1066806

Laboratory TypePhysician Office

Certificate Effective DateApril 3, 2025

Certificate Expiration DateApril 2, 2027

Laboratory DirectorDr. Jack Fatiha

Laboratory Phone(718) 336-0100

Laboratory LocationJack Fatiha MD701 Avenue U, Brooklyn, NY 11223

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 12

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 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.

501 services115 patients

Insertion of needle into vein (3 years or older) 36410

This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.

201 services93 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.

142 services76 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

113 services61 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

57 services28 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

47 services29 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

42 services38 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

36 services28 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

23 services12 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

22 services22 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b 87636

This test detects the presence of SARS-CoV-2 (COVID-19) and Influenza types A and B in your body. It uses a method called the multiplex amplified probe technique to amplify and identify specific virus genes. It helps in early diagnosis and appropriate treatment.

15 services13 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Maimonides Medical Center

Acute Care Hospitals · Brooklyn, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330194

Location4802 Tenth AvenueBrooklyn, NY 11219 · Kings County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11223 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

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

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.

Other Providers at the Same Location NPPES 3

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

DR. MAYA MOUAZEB DDS

Dentist (General Practice)

709 AVENUE U
BROOKLYN, NY 11223

Kings County (718) 336-0100

JACK FATIHA MD PC

Clinic/Center (Health Service)

709 AVENUE U
BROOKLYN, NY 11223

Kings County (718) 336-0100

MOUAZEB DENTAL PC

Dentist

709 AVENUE U
BROOKLYN, NY 11223

Kings County (718) 336-0100

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 Jack Fatiha's NPI number?

The NPI number for Jack Fatiha is 1619969177. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Where is Jack Fatiha located?

Jack Fatiha practices at 709 Avenue U, Brooklyn, NY 11223. The listed phone number is (718) 336-0100.

What is Jack Fatiha's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jack Fatiha enrolled in Medicare?

Yes. Jack Fatiha 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.

Does Jack Fatiha hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1066806) is associated with this NPI, valid through April 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Jack Fatiha affiliated with any hospitals?

According to CMS data, Jack Fatiha is affiliated with Maimonides Medical Center.

When was this NPI record last updated?

The NPPES record for Jack Fatiha was last updated on April 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

About Dr. Jack Fatiha M.d. NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 3

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 33D1066806

Areas of Expertise CMS Part B claims 12

Hospital Affiliations CMS Care Compare

Maimonides Medical Center

Physician Visit Costs CMS claims · ZIP area

Other Providers at the Same Location NPPES 3

Frequently Asked Questions NPPES & CMS

What is Jack Fatiha's NPI number?

Where is Jack Fatiha located?

What is Jack Fatiha's specialty?

Is Jack Fatiha enrolled in Medicare?

Does Jack Fatiha hold a CLIA laboratory certificate?

Is Jack Fatiha affiliated with any hospitals?

When was this NPI record last updated?

Certificate of Waiver 33D1066806