FAZILATH FATIMA (MD) – Internal Medicine Physician, NPI 1962429571

FAZILATH FATIMA (MD) is a healthcare provider. based in Fountain valley, California. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 4301079615 (MI). The NPI Number for FAZILATH FATIMA (MD) is 1962429571

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
FAZILATH FATIMA (MD)
NPI
1962429571
Phone
(657) 241-3592
Address
17360 BROOKHURST ST
Enumeration Date
17 July 2006
Last Update Date
9 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7145576300
Graduation Year
2000 (26 years ago)
PAC ID
4981706074
Group Practice PAC ID
8729277314
Professional Enrollment ID
I20150814012627
Address ID
CA926264320CO722XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience75
Completeness75
Years active:19State licenses:3Digital endpointsOther names

21,558 INTERNAL MEDICINE in CA

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Provider Addresses for FAZILATH FATIMA (MD)

  • 17360, Brookhurst Street, Colonia Juarez, Fountain Valley, Orange County, California, 92708, United States

    FOUNTAIN VALLEY, CA 927083720

    Phone: (657) 241-3592

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150814012627IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes16363$0
99239Hospital discharge day management, more than 30 minutes3333$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2828$0
View full utilization report →

Insurance plans in this area (ZIP 92708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729277314View full group profile
NameSpecialtyState
-CA
Diagnostic RadiologyCA
Hospitalist, Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Internal Medicine, Pediatric MedicineCA
Nurse PractitionerCA
Neurology, Internal MedicineCA
-CA
-CA

Reviews

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Frequently asked questions

Does FAZILATH FATIMA (MD) have a public NPI I can cite?
Public records show FAZILATH FATIMA (MD) under NPI 1962429571.
Is FAZILATH FATIMA (MD) currently accepting referrals based on NPI status?
Registry metadata lists FAZILATH FATIMA (MD) as active.
What does the directory say FAZILATH FATIMA (MD) does?
Insurance directories may phrase it differently, but here FAZILATH FATIMA (MD) maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is FAZILATH FATIMA (MD) tied to Fountain Valley, California?
If you are local to Fountain Valley, California, FAZILATH FATIMA (MD) may be relevant to your search.
Can I export FAZILATH FATIMA (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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