Individual provider Active NPI

Ikramamul Latif Nibir, DO

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1134864093
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS21340 Issued in FL
Practice address
Florida Atlantic University Internal Medicine Residency
800 Meadows Road
Boca Raton, FL 33415
Phone
(561) 955-9365
NPI assigned
May 4, 2022
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X OS21340 FL Primary

Addresses

Primary practice location

Florida Atlantic University Internal Medicine Residency
800 Meadows Road
Boca Raton, FL 33415

Mailing address

Florida Atlantic University Internal Medicine Residency
800 Meadows Road
Boca Raton, FL 33486
Phone (561) 955-5365

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250915000731 FL Practitioner - Internal Medicine 0143609081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collins Physician Services, LLCGroup PAC ID 9234476920, 48 clinicians

Practice addresses (Care Compare)

4300 Alton Rd
Miami, FL 33140-2948
Phone (305) 481-9776

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Collins Physician Services, LLC Internal Medicine CurrentSince Aug 5, 2025 Accepting new patients

Locations

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

200 Corporate Blvd
Lafayette, LA 70508

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1134864093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FLORIDA ATLANTIC UNIVERSITY INTERNAL MEDICINE RESIDENCY",
            "address_2": "800 MEADOWS ROAD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33486",
            "telephone_number": "561-955-5365",
            "fax_number": "561-955-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FLORIDA ATLANTIC UNIVERSITY INTERNAL MEDICINE RESIDENCY",
            "address_2": "800 MEADOWS ROAD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33415",
            "telephone_number": "561-955-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBIR",
        "first_name": "IKRAMAMUL",
        "middle_name": "LATIF",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.