Brian Ibabao, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MA11741700 Issued in NJ

Practice address

111 E 210TH St
Bronx, NY 10467-2401

Phone

(718) 920-4321

NPI assigned

Mar 28, 2019

Last updated

May 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Anesthesiology

Education

State University of Ny Upstate Medical University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergen Anesthesia Group, P.C.Group PAC ID 6608861794, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Hospital Hospital, Paramus, NJ, CCN 310012

Merit-based Incentive Payment System (MIPS)

Final score

60.05 of 100Reported as group

Quality

46.59

Improvement activities

40

Cost

64.74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Bergen Anesthesia Group, P.C.

  • Specialist
  • Ridgewood, NJ
  • NPI 1194816249
  Medicare reassignment Care Compare group NPD

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

• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  Care Compare affiliation

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1114488418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST STE 16",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811406",
            "telephone_number": "201-847-9320",
            "fax_number": "201-847-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 N Van Dien Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074502726",
            "country_code": "US",
            "telephone_number": "201-847-9320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBABAO",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA11741700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mihai Cristian Iacob, M.D.
• Daniela Iacoboni, MS, CGC
• Frank Michael Iacovone Jr., M.D.
• Anne Iannuzzi, LMSW
• Michelle Iannuzzi, MA CCC SLP
• Jesse Astur Ibanez, DMD
• Lulu H Ibanez, RPAC
• Pablo Freije Ibanez, MD
• Sarah Ibardolaza, OTR/L
• Astrid Ibarra, LMSW

• Anesthesiology Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.