Individual provider Active NPI

Hussein Ibrahim

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1043428964
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026104-1 Issued in NY
Practice address
1250 67TH St
Brooklyn, NY 11219-5921
Phone
(718) 232-2322
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 026104-1 NY Primary

Addresses

Primary practice location

1250 67TH St
Brooklyn, NY 11219-5921

Mailing address

170 72ND St
Apt 581
Brooklyn, NY 11209-2065

Other practice location 1

255 W Spring Valley Ave Ste 109
Maywood, NJ 07607-1444
Phone (201) 300-9897

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
026104-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Home Health LLC CurrentSince Oct 22, 2014 Accepting new patients
Virginia Healthcare Services of the Valley LLC CurrentSince Jun 30, 2015 Accepting new patients
Virginia Healthcare Services of Richmond LLC PastSince Dec 1, 2010 Accepting new patients
Move Free Rehab Center LLC PastSince Oct 13, 2010 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1043428964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 72ND ST",
            "address_2": "APT 581",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 67TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195921",
            "telephone_number": "718-232-2322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 W Spring Valley Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "NJ",
            "postal_code": "076071444",
            "country_code": "US",
            "telephone_number": "201-300-9897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "HUSSEIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026104-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.