NPIMap

Individual provider Active NPI

Ibrahim Mustafa Khalifeh, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Cincinnati, OH
National Provider Identifier
1174784441
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
35.142280 Issued in OH
Practice address
2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone
(513) 585-2000
NPI assigned
Jun 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD485087 PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35.142280 OH Primary

Addresses

Primary practice location

2139 Auburn Ave
Cincinnati, OH 45219-2906

Mailing address

619 19TH St S
Birmingham, AL 35249-1900

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-4353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506000182 PA Practitioner - Pathology 6507265881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196
  • Temple Health - Chestnut Hill Hospital Hospital, Philadelphia, PA, CCN 390026

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Merit-based Incentive Payment System (MIPS)

Final score
90.59 of 100Reported as group
Quality
93.8
Improvement activities
40
Cost
79.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.142280OHMDAnatomic Pathology & Clinical Pathology Physician
MD485087PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 1, 2024 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince May 1, 2024 Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

Organizations & group practices 3

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 10

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1174784441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352491900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-585-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-4353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIFEH",
        "first_name": "IBRAHIM",
        "middle_name": "MUSTAFA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD485087",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35.142280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.