Active NPI
Mohamed Ibrahim
- Transportation Broker
- Aurora, CO
National Provider Identifier
1033816236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transportation Broker
- License
- 11-314-0189
- Practice address
- 2195 S Joliet St
Aurora, CO 80014-1034 - Phone
- (720) 936-5606
- NPI assigned
- Feb 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transportation Broker | 347E00000X | 11-314-0189 | CO | Primary |
Addresses
Primary practice location
2195 S Joliet St
Aurora, CO 80014-1034
Mailing address
2195 S Joliet St
Aurora, CO 80014-1034
Phone (720) 936-5606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000178887 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-314-0189 | CO | MD | Transportation Broker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675814400000",
"number": "1033816236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2195 S JOLIET ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800141034",
"telephone_number": "720-936-5606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2195 S JOLIET ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800141034",
"telephone_number": "720-936-5606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MOHAMED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-08",
"last_updated": "2023-02-08",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "347E00000X",
"taxonomy_group": "",
"desc": "Transportation Broker",
"state": "CO",
"license": "11-314-0189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000178887",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.