NPIMap

Individual provider Active NPI

Ibrahim Sameh Ibrahim Fanous, MD

  • Internal Medicine Physician
  • McKeesport, PA
National Provider Identifier
1013433416
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD471035 Issued in PA
Practice address
1500 Fifth Ave FL 1
McKeesport, PA 15132-2422
Phone
(412) 664-2782
Fax
(412) 664-2784
NPI assigned
Aug 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD471035 PA Primary

Addresses

Primary practice location

1500 Fifth Ave FL 1
McKeesport, PA 15132-2422

Mailing address

1500 Fifth Ave FL 1
McKeesport, PA 15132-2422
Phone (412) 664-2782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014000032 PA Practitioner - Internal Medicine 6901165281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upmc Community Medicine IncGroup PAC ID 2062318975, 736 clinicians

Practice addresses (Care Compare)

1318 5TH Ave
McKeesport, PA 15132-2489
Phone (412) 672-1000

Hospital & facility affiliations

  • Amedisys Home Health of PA Home health agency, Uniontown, PA, CCN 397139
  • Upmc Home Healthcare Home health agency, Seven Fields, PA, CCN 397636
  • Upmc McKeesport Hospital Hospital, MC Keesport, PA, CCN 390002
  • Upmc East Hospital, Monroeville, PA, CCN 390328
  • Magee Womens Hospital of Upmc Health System Hospital, Pittsburgh, PA, CCN 390114
  • Excela Health Westmoreland Regional Hospital Hospital, Greensburg, PA, CCN 390145
  • Upmc Presbyterian Shadyside Hospital, Pittsburgh, PA, CCN 390164
  • Select Specialty Hospital - McKeesport, Inc Long-term care hospital, MC Keesport, PA, CCN 392045

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
70.53
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD471035PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc CurrentSince Oct 1, 2020 Accepting new patients
Upmc Community Medicine Inc CurrentSince Oct 1, 2020 Accepting new patients
Upmc Community Medicine, Inc Internal Medicine Current Accepting new patients
Select Specialty Hospital - McKeesport Inc Past Accepting new patients
Upmc Community Medicine Inc Internal Medicine PastSince Sep 27, 2020 Accepting new patients
Upmc McKeesport Past Accepting new patients
Upmc East Past Accepting new patients

Locations

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

1318 5th Ave
Ste 1
McKeesport, PA 15132
Phone (412) 672-1000

1500 5th Ave
McKeesport, PA 15132
Phone (412) 664-2167

1500 5th Ave
Fl 1
McKeesport, PA 15132
Phone (412) 664-2782

400 Oxford Dr
Ste 202
Monroeville, PA 15146
Phone (412) 380-5040

2 Hot Metal St
#1
Pittsburgh, PA 15203
Phone (412) 432-5866

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

2001 Lincoln Way
Ste 290
White Oak, PA 15131
Phone (412) 267-5969

Interoperability endpoints

  • Direct secure messaging: ibrahim.s.fanous2@upmcdirect.com
  • Direct secure messaging: ibrahim.fanous@somc.medicity.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1013433416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 FIFTH AVE FL 1",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151322422",
            "telephone_number": "412-664-2782",
            "fax_number": "412-664-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FIFTH AVE FL 1",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151322422",
            "telephone_number": "412-664-2782",
            "fax_number": "412-664-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANOUS",
        "first_name": "IBRAHIM",
        "middle_name": "SAMEH IBRAHIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD471035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

Verify at the official NPI Registry.