Christine Ibrahim, M.D.
Individual provider Active NPI Family Medicine Physician · Port Monmouth, NJ
NPI 1114158987 · NPPES record last updated Feb 21, 2014
Key facts
- NPI
- 1114158987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 25MA09067400 (NJ)
- Practice address
- 363 Hwy 36
Port Monmouth, NJ 07758-1359 - Phone
- (732) 471-0400
- Fax
- (732) 471-7949
- NPI assigned
- Jul 28, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care Physicians of New Jersey LLC
Practice addresses (Care Compare)
319 US Hwy 130
East Windsor, NJ 08520-2735
Phone (609) 426-4300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120829000238 | NJ | Practitioner - Family Practice | 1658528575 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09067400 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Physicians of New Jersey, LLC | Current |
Accepting new patients | |
| Immediate Care Medical Walk-in of Hazlet, PA | Family Medicine | Current |
Accepting new patients |
| Ima Urgent Care | Past |
Accepting new patients |
Locations
319 US Highway 130
East Windsor, NJ 08520
Phone (609) 426-4300
561 US Highway 1
Edison, NJ 08817
Phone (732) 933-0950
1376 State Route 36
Hazlet, NJ 07730
Phone (732) 264-5500
46 Newman Springs Rd E
Ste F
Red Bank, NJ 07701
Phone (732) 933-4100
1 Route 37 W
Toms River, NJ 08753
Phone (732) 281-3201
Interoperability endpoints
- christine.ibrahim@immcarenj.directbygreenway.com
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA09067400 | NJ | Yes |
Addresses
Primary practice location
363 Hwy 36
Port Monmouth, NJ 07758-1359
Mailing address
PO Box 8519
Red Bank, NJ 07701-8519
Phone (732) 460-9840
Other providers in Port Monmouth, NJ
- Brianne Dwyer
- Eckerd Corporation
- Jay Hochheiser
- Home Stretch Consulting, LLC
- Horizon Mental Wellness LLC
- Yasmeen Jafry
- Christopher Johnston
- Christine Kim
- Tracey A Licciardi
- Ruth Marietta
All providers in Port Monmouth, NJ · Family Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.