Active NPI
John Ibarra, M.D.
- Diagnostic Radiology Physician
- Miami, FL
National Provider Identifier
1063464865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 162320-1
- Practice address
- 3663 S Miami Ave
Miami, FL 33133-4253 - Phone
- (305) 854-4400
- Fax
- (305) 285-5068
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 162320-1 | NY | Primary |
Addresses
Primary practice location
3663 S Miami Ave
Miami, FL 33133-4253
Mailing address
PO Box 166474
Miami, FL 33116-6474
Phone (855) 826-6460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01911884 | Medicaid | NY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162320-1 | NY | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Imaging, LLC | Diagnostic Radiology | Past | Accepting new patients |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Aventura, FL
- NPI 1942208319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1063464865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 166474",
"city": "MIAMI",
"state": "FL",
"postal_code": "331166474",
"telephone_number": "855-826-6460",
"fax_number": "772-621-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3663 S MIAMI AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331334253",
"telephone_number": "305-854-4400",
"fax_number": "305-285-5068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "162320-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01911884",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.