DR. AHMED FATHALA (MD) – Internal Medicine Physician, NPI 1184604696

DR. AHMED FATHALA (MD) is a healthcare provider. based in Clinton, Iowa. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 34418 (IA). The NPI Number for DR. AHMED FATHALA (MD) is 1184604696

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. AHMED FATHALA (MD)
NPI
1184604696
Phone
(563) 242-3208
Address
2745 LINCOLN WAY
Enumeration Date
19 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2168441000
Graduation Year
1991 (35 years ago)
PAC ID
0749273514
Group Practice PAC ID
4789682493
Professional Enrollment ID
I20250217000501
Address ID
OH441061716CL11100AVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

434 DIAGNOSTIC RADIOLOGY in IA

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Provider Addresses for DR. AHMED FATHALA (MD)

  • 2745, Lincoln Way, Clinton, Clinton County, Iowa, 52732, United States

    CLINTON, IA 527327201

    Phone: (563) 242-3208

    Fax: (563) 242-4051

    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: 2025-02-17

PECOS data refreshed: 2026-05-27

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
I20250217000501IDiagnostic RadiologyOHTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 52732)

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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: 4789682493View full group profile
NameSpecialtyState
-OH
-MI
Hospitalist, Internal MedicineOH
-TX
-OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
O B S T E T R I C S/ G Y N E C O L O G YOH
-OH
-OH

Reviews

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Frequently asked questions

Does DR. AHMED FATHALA (MD) have a public NPI I can cite?
Public records show DR. AHMED FATHALA (MD) under NPI 1184604696.
Does the public listing show DR. AHMED FATHALA (MD) as active?
DR. AHMED FATHALA (MD)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. AHMED FATHALA (MD)'s specialty?
The extract shows Internal Medicine Physician for DR. AHMED FATHALA (MD). Clinical services aligned with this taxonomy classification.
What city is tied to DR. AHMED FATHALA (MD)?
The directory associates DR. AHMED FATHALA (MD) with Clinton, Iowa. Check all listed addresses for suites or satellite offices.
Who maintains DR. AHMED FATHALA (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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