Christine Ibrahim, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09067400 Issued in NJ

Practice address

363 Hwy 36
Port Monmouth, NJ 07758-1359

Phone

(732) 471-0400

Fax

(732) 471-7949

NPI assigned

Jul 28, 2009

Last updated

Feb 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

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 LLCGroup PAC ID 1658674585, 96 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christine.ibrahim@immcarenj.directbygreenway.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402
  Medicare reassignment Care Compare group NPD
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313

  Family Medicine

  Medicare reassignment NPD
• Ima Urgent Care

  • Urgent Care Clinic/Center
  • Shrewsbury, NJ
  • NPI 1427432244
  NPD (past)

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1114158987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8519",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077018519",
            "telephone_number": "732-460-9840",
            "fax_number": "732-460-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HWY 36",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581359",
            "telephone_number": "732-471-0400",
            "fax_number": "732-471-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09067400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Dwyer, RBT
• Eckerd Corporation (Rite Aid Pharmacy 10425)
• Jay Hochheiser, L.C.S.W.
• Home Stretch Consulting, LLC
• Horizon Mental Wellness LLC
• Yasmeen Jafry, MD
• Christopher Johnston, M.D.
• Christine Kim, NP-C
• Tracey A Licciardi, RPH
• Ruth Marietta, RPH

• Family Medicine Physician in Port Monmouth, NJ
• Providers in Port Monmouth, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.