Fatima Ebrahim

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351053589 Issued in MI

Practice address

3175 W. Professional Drive, Suite 1
Bay City, MI 48706

Phone

(989) 895-4625

NPI assigned

Jun 26, 2024

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 MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• McLaren Bay Region

  • Psychologist
  • Essexville, MI
  • NPI 1013056233
  NPD (past)
• McLaren Bay Region

  • Psychiatry Physician
  • Bay City, MI
  • NPI 1942560339
  NPD (past)

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1124863832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 W. PROFESSIONAL DRIVE, SUITE 1",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-895-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 W. PROFESSIONAL DRIVE, SUITE 1",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-895-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "FATIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351053589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Dymek, M.D.
• Jennifer Dziurka
• Kristy Dzurka
• Tiffany Rose Eager
• East Side Family Physicians PC
• Ashle Ecker
• Erica Lynn Eckert
• Tim E Eckstein, DO
• Claire Elizabeth Economou
• Julianna Consuelo Eddy

• Student in an Organized Health Care Education/Training Program in Bay City, MI
• Providers in Bay City, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.