Individual provider Active NPI

Rawaa Ebrahem, M.D.

  • Rheumatology Physician
  • Wichita, KS
National Provider Identifier
1104206077
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
TRN27052 Issued in FL
Practice address
1921 N Webb Rd
Wichita, KS 67206-3405
Phone
(316) 612-4815
Fax
(316) 612-4825
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 94-08572 KS
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 04-43181 KS
Rheumatology Physician 207RR0500X TRN27052 FL Primary

Addresses

Primary practice location

1921 N Webb Rd
Wichita, KS 67206-3405

Mailing address

1921 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 612-4815

Other identifiers 1

IdentifierTypeStateIssuer
201294670AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rawaa.ebrahem@direct.arck.nextgenshare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200609001180 KS Practitioner - Rheumatology 5799099883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1921 N Webb Rd
Wichita, KS 67206-3405
Phone 31661248151280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Quality
97.45
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-08572KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis and Rheumatology Clinics of Kansas LLC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients
Arthritis and Rheumatology Clinics of Kansas LLC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients

Locations

1921 N Webb Rd
Wichita, KS 67206
Phone (316) 612-4815

13205 W 21st Ct N
Wichita, KS 67235
Phone (316) 612-4815

Interoperability endpoints

  • Direct secure messaging: rawaa.ebrahem@direct.arck.nextgenshare.com
  • Direct secure messaging: rebrahem333187@direct.shands.ufl.edu

Organizations & group practices 2

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1104206077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-612-4815",
            "fax_number": "316-612-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-612-4815",
            "fax_number": "316-612-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHEM",
        "first_name": "RAWAA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "94-08572",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KS",
            "license": "04-43181",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "TRN27052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201294670A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rawaa.ebrahem@direct.arck.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR messaging",
            "address_1": "1921 N Webb Rd",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672063405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.