Fady R Ibrahim, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OP61459797 Issued in WA

Practice address

602 E Nob Hill Blvd
Yakima, WA 98901-3534

Phone

(509) 248-3334

Fax

(509) 865-0757

NPI assigned

Mar 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Pacific NW Un of HS, Col of Osteopathic Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health of Central WashingtonGroup PAC ID 4183536931, 77 clinicians

Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1598764920
  Medicare reassignment Care Compare group NPD
• Yakima Valley Farm Workers Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Yakima, WA
  • NPI 1295788602
  Medicare reassignment Care Compare group NPD
• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Tieton, WA
  • NPI 1700255874
  NPD
• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1033677307
  NPD
• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Clatskanie, OR
  • NPI 1578000345
  NPD

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1144970153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-853-2395",
            "fax_number": "509-865-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334",
            "fax_number": "509-865-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023115",
            "country_code": "US",
            "telephone_number": "509-574-6136",
            "fax_number": "509-452-5224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-814-2115",
            "fax_number": "360-428-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "FADY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61459797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2213746",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hygate Properties, Inc.
• Hyperbaric Centers of Washington
• Andrea Nicole Iasella, DMD
• John M Iasella, DDS MS
• Sandra Selene Ibarra Valencia
• Maryam Jihad Ibrahim, MD
• Miranda Ice
• Ideal Option, PLLC
• Igor Elperin DDS, PLLC
• Yesenia Iman

• Internal Medicine Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.

Verify at the official NPI Registry.