Active NPI
Mena Ibrahim, DPM
- Foot & Ankle Surgery Podiatrist
- Laguna Hills, CA
National Provider Identifier
1124716907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E6243
- Practice address
- 23141 Moulton Pkwy Ste 109
Laguna Hills, CA 92653-1241 - Phone
- (949) 272-0007
- NPI assigned
- Apr 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E6243 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NJ |
Addresses
Primary practice location
23141 Moulton Pkwy Ste 109
Laguna Hills, CA 92653-1241
Mailing address
350 Engle St
Englewood, NJ 07631-1898
Phone (201) 894-3000
Other practice location 1
350 Engle St
Englewood, NJ 07631-1898
Phone (201) 894-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1660 Feehanville Dr
Suite 450
Mount Prospect, IL 60056-6019
PO Box
Los Angeles, CA 90084
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1124716907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 ENGLE ST",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076311898",
"telephone_number": "201-894-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23141 MOULTON PKWY STE 109",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926531241",
"telephone_number": "949-272-0007"
}
],
"practiceLocations": [
{
"address_1": "350 Engle St",
"address_purpose": "LOCATION",
"city": "Englewood",
"state": "NJ",
"postal_code": "076311898",
"country_code": "US",
"telephone_number": "201-894-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MENA",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-28",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E6243",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NJ",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.