DR. ERNST FATTAKHOV (MD) – Emergency Medicine Physician, NPI 1164046744

DR. ERNST FATTAKHOV (MD) is a healthcare provider. based in Lafayette, Louisiana. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. U3839 (TX). The NPI Number for DR. ERNST FATTAKHOV (MD) is 1164046744

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. ERNST FATTAKHOV (MD)
NPI
1164046744
Phone
(800) 893-9698
Address
200 CORPORATE BLVD
Enumeration Date
30 May 2020
Last Update Date
11 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4098927171
Graduation Year
2020 (6 years ago)
PAC ID
3072974997
Group Practice PAC ID
4880048560
Professional Enrollment ID
I20230725002272
Address ID
TX777021809BE2830XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

4,917 EMERGENCY MEDICINE in NY

Provider Addresses for DR. ERNST FATTAKHOV (MD)

  • 200 CORPORATE BLVD

    LAFAYETTE, LA 705083870

    Phone: (800) 893-9698

    Type: Mailing

  • 707 E MAIN ST

    MIDDLETOWN, NY 109402650

    Phone: (845) 333-6333

    Type: Location

  • 25 FAIRWAYS DR UNIT 12

    MIDDLETOWN, NY 109402680

    Phone: (312) 612-0002

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $50.

Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.

Last reported payment date: 2024-11-15 • Largest payer in this snapshot: ABBVIE INC. ($50).

Total Amount

$50

General + Research + Ownership

Payments

3

Total payment records

General Amount

$50

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-15

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$50
View all Open Payments →|Open Payments Risk Radar →

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: 2023-07-25

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
I20230725002272IEmergency MedicineTXTBD

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
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only176157$0
99285Emergency department visit with high level of medical decision making147145$0
99291Critical care, first 30-74 minutes5048$0
99284Emergency department visit with moderate level of medical decision making1212$0
View full utilization report →

Insurance plans in this area (ZIP 70508)

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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: 4880048560View full group profile
NameSpecialtyState
Emergency MedicineTX
Emergency MedicineNY
Emergency Medicine, Family PracticeLA
Emergency MedicineTX
Emergency MedicineTX
Nurse PractitionerTX
Emergency MedicineLA
Internal Medicine, Emergency MedicineTX
Emergency MedicineNM
Emergency MedicineTX

Reviews

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Frequently asked questions

Is DR. ERNST FATTAKHOV (MD) listed with a National Provider Identifier?
Yes — DR. ERNST FATTAKHOV (MD) has NPI 1164046744 on file in the registry.
Is there an active status for DR. ERNST FATTAKHOV (MD)?
For scheduling context, DR. ERNST FATTAKHOV (MD) is shown as active in the registry.
What expertise is attributed to DR. ERNST FATTAKHOV (MD)?
DR. ERNST FATTAKHOV (MD)'s specialty line reads Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. ERNST FATTAKHOV (MD)?
Travel planning: use Lafayette, Louisiana as the reference point for DR. ERNST FATTAKHOV (MD), then confirm.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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