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MICHAEL FATHALLA DO
NPI 1912793183
Student in an Organized Health Care Education/Training Program in Chardon, OH

Active since April 16, 2025PECOS Enrolled
13207 RAVENNA RD, CHARDON, OH 44024(440) 285-6000 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michael Fathalla Do NPPES

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

MICHAEL FATHALLA DO (NPI 1912793183) is an individual student in an organized health care education/training program in Chardon, Ohio and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912793183
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMICHAEL FATHALLACredential: DO
Location Address13207 RAVENNA RDChardon, OH 44024-7032
Mailing Address13207 Ravenna RdChardon, OH 44024-7032
Phone(440) 285-6000
Sole ProprietorNo
Enumeration DateApril 16, 2025
NPPES CertifiedApril 4, 2025
✔ NPI 1912793183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
13207 RAVENNA RD, Chardon, OH 44024
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Fathalla Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

ROBERT J. ZIMMERMAN M.D.
Emergency Medicine
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (440) 285-6000
DR. HALEY HOWARD PHARMD
Pharmacist
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (440) 285-6000
LAVANYA GALI MD
Student in an Organized Health Care Education/Training Program
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (440) 285-6000
SHIVAM BHAVESH BHATT DO
Family Medicine
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (440) 585-6553
DR. MARTIN MACKLIN M.D.
Psychiatry & Neurology (Addiction Psychiatry)
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (440) 269-6595
MAETINEE LOPARO NP-C
Nurse Practitioner
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (330) 656-9304
SAMUEL BOGGESS
Student in an Organized Health Care Education/Training Program
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (877) 356-0756
AHMAD HOURY MD
Student in an Organized Health Care Education/Training Program
13207 RAVENNA RD
CHARDON, OH 44024
Geauga County (216) 262-8718

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 Michael Fathalla's NPI number?

The NPI number for Michael Fathalla is 1912793183. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Michael Fathalla located?

Michael Fathalla practices at 13207 Ravenna Rd, Chardon, OH 44024. The listed phone number is (440) 285-6000.

What is Michael Fathalla's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Fathalla enrolled in Medicare?

Yes. Michael Fathalla is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Michael Fathalla was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.