Mohamed M Ibrahim, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35087769 Issued in OH

Practice address

15 Elizabeth Dr
Lockport, NY 14094-5226

Phone

(716) 341-3983

Fax

(716) 433-6388

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Wound Doctors of Ny PLLC

  • Surgery Physician
  • Batavia, NY
  • NPI 1225558463
  NPD Authorized official
• United Memorial Medical Center

  • Family Medicine Physician
  • Batavia, NY
  • NPI 1669747085

  Surgery

  NPD
• United Memorial Medical Center

  • General Acute Care Hospital
  • Batavia, NY
  • NPI 1902800352
  NPD
• University of Toledo Physicians LLC

  • Internal Medicine Physician
  • Toledo, OH
  • NPI 1942296033

  Surgery

  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1154379295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-341-3983",
            "fax_number": "716-433-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-341-3983",
            "fax_number": "716-433-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MOHAMED",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35087769",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35087769",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02836482",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew House, PHARMD
• Maria Howard, RN
• Michelle Lynn Howe, M. ED.
• Thomas Hughes, MD
• Alix Hutchison
• Indian Health Service Lockport IHS Health Center
• Innovateu, LLC.
• Kathryn Adele Iraci, MSW
• Judy Izard, RPH
• Michele Mary Jackson, OTR/L

• Surgery Physician in Lockport, NY
• Providers in Lockport, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.