Active NPI
Huzifa Haj-Ibrahim, M.D
- Surgery Physician
- Boston, MA
National Provider Identifier
1124401690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 264381
- Practice address
- 400 Brookline Ave Apt 20G
Boston, MA 02215-5409 - Phone
- (617) 650-6013
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 264381 | MA | Primary |
Addresses
Primary practice location
400 Brookline Ave Apt 20G
Boston, MA 02215-5409
Mailing address
400 Brookline Ave Apt 20G
Boston, MA 02215-5409
Phone (617) 650-6013
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 264381 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1124401690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 BROOKLINE AVE APT 20G",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155409",
"telephone_number": "617-650-6013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 BROOKLINE AVE APT 20G",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155409",
"telephone_number": "617-650-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAJ-IBRAHIM",
"first_name": "HUZIFA",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-02",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "264381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.