Organization Active NPI

North Broadway Medical Family Practice PC

  • Primary Care Clinic/Center
  • Yonkers, NY
National Provider Identifier
1134009384
Registry record updated Sep 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTH BROADWAY MEDICAL FAMILY PRACTICE PC
Practice address
469 N Broadway
Dr. Noor Ibraheem
Yonkers, NY 10701-1960
Phone
(914) 359-8750
NPI assigned
Sep 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2025

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

Authorized official

Name
Dr. Noor Ibraheem, MDNPI 1538809579
Title
Physician Owner
Phone
(914) 359-8750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

469 N Broadway
Dr. Noor Ibraheem
Yonkers, NY 10701-1960

Mailing address

469 N Broadway
Dr. Noor Ibraheem
Yonkers, NY 10701-1960
Phone (914) 359-8750

Other identifiers 1

IdentifierTypeStateIssuer
338031OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250930003840 NY Part B Supplier - Clinic/Group Practice 7416453337 Receives reassigned benefits from 1 practitioner
Practice locations: Yonkers, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757116800000",
    "number": "1134009384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 N BROADWAY",
            "address_2": "DR. NOOR IBRAHEEM",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011960",
            "telephone_number": "914-359-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 N BROADWAY",
            "address_2": "DR. NOOR IBRAHEEM",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011960",
            "telephone_number": "914-359-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROADWAY MEDICAL FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-06",
        "last_updated": "2025-09-06",
        "certification_date": "2025-09-06",
        "status": "A",
        "authorized_official_last_name": "IBRAHEEM",
        "authorized_official_first_name": "NOOR",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "914-359-8750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "338031",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.