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BOUTHIANA FATHALLAH CAA
NPI 1861223661
Anesthesiologist Assistant in Trinity, FL

Active since August 12, 2024Accepts Medicare Assignment
9330 STATE ROAD 54, TRINITY, FL 34655(727) 834-4000 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bouthiana Fathallah Caa NPPES

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

BOUTHIANA FATHALLAH CAA (NPI 1861223661) is an individual anesthesiologist assistant in Trinity, Florida and active in the NPI registry since August 2024. She is affiliated with Hca Florida Trinity Hospital and is a graduate of Other (2024).

NPPES Registry Identity

NPI1861223661
Entity TypeIndividualFemale
Primary Taxonomy367H00000X
Provider Legal NameBOUTHIANA FATHALLAHCredential: CAA
Location Address9330 STATE ROAD 54Trinity, FL 34655-1808
Mailing Address1808 Shadybrook RdCharleston, WV 25314-2268
Phone(727) 834-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 12, 2024
NPPES CertifiedAugust 12, 2024
✔ NPI 1861223661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
9330 STATE ROAD 54, Trinity, FL 34655
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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

Bouthiana Fathallah Caa 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 ID4789118589
PECOS Enrollment IDI20260424001257

Medicare Billing Reassignment

Medicare enrollment records show Bouthiana Fathallah reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Piedmont Anesthesia LLC
377 mi
Anesthesiology
1133 EAGLES LANDING PKWY
Stockbridge, GA 30281
  • Reassigned Medicare billing, Georgia enrollment
  • 713 clinicians in this Medicare group
NPI 1700474244 (678) 604-1053

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

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Trinity Hospital

Acute Care Hospitals · Trinity, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100191
Location9330 Sr 54Trinity, FL 34655 · Pasco County
Emergency services Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

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. KENNY HERNANDEZ MD
Internal Medicine
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 834-4000
DR. ANGELEKE VAKIAROS PHARMD, MBA
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 834-4972
ARIELLE CRYSTAL KIRK
Student in an Organized Health Care Education/Training Program
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 834-4868
HANNAN ODEH MD
Student in an Organized Health Care Education/Training Program
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 858-9589
GAUTHIER LUC STEPMAN MD
Internal Medicine
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 834-4000
TIMOTHY PETRU BEUCA DO
Internal Medicine
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 834-4830
DR. WAHAB AKINOLA GBADAMOSI MD
Radiology (Diagnostic Radiology)
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (478) 832-2290
OLUWATOYOSI AWOTOREBO
Student in an Organized Health Care Education/Training Program
9330 STATE ROAD 54
TRINITY, FL 34655
Pasco County (727) 858-9589

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 Bouthiana Fathallah's NPI number?

The NPI number for Bouthiana Fathallah is 1861223661. It was assigned to this individual provider in the NPPES registry on August 12, 2024.

Where is Bouthiana Fathallah located?

Bouthiana Fathallah practices at 9330 State Road 54, Trinity, FL 34655. The listed phone number is (727) 834-4000.

What is Bouthiana Fathallah's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Bouthiana Fathallah enrolled in Medicare?

Yes. Bouthiana Fathallah 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.

Which organization bills Medicare for Bouthiana Fathallah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bouthiana Fathallah reassigns Medicare benefits to Piedmont Anesthesia LLC (Stockbridge, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bouthiana Fathallah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Bouthiana Fathallah affiliated with any hospitals?

According to CMS data, Bouthiana Fathallah is affiliated with Hca Florida Trinity Hospital and Piedmont Henry Hospital.

When was this NPI record last updated?

The NPPES record for Bouthiana Fathallah was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.