NPIMap

Individual provider Active NPI

Rami Ibrahim

  • Diagnostic Radiology Physician
  • New Hyde Park, NY
National Provider Identifier
1154819217
Registry record updated Sep 20, 2023
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Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13286427-1205 Issued in UT
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(920) 420-3302
NPI assigned
Apr 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13286427-1205 UT Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231004001116 UT Practitioner - Diagnostic Radiology 7113371592 Reassigns benefits to 1 organization
I20240210000673 WY Practitioner - Diagnostic Radiology 7113371592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical Imaging LLCGroup PAC ID 9436159415, 3 clinicians

Practice addresses (Care Compare)

1200 College Dr
Rock Springs, WY 82901-5868
Phone (786) 621-3900

Hospital & facility affiliations

  • Memorial Hospital Sweetwater County Hospital, Rock Springs, WY, CCN 531318
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
76.2
Improvement activities
40
Cost
74.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13286427-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Aug 21, 2023 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Aug 21, 2023 Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1154819217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "920-420-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "RAMI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "13286427-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.