Individual provider Active NPI

Ibrahim S Fakhoury, MD

  • Nephrology Physician
  • Abilene, TX
National Provider Identifier
1245226927
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
K4680 Issued in TX
Practice address
1904 Pine St
Suite 4B
Abilene, TX 79601-2449
Phone
(325) 670-4494
Fax
(325) 670-4497
NPI assigned
Sep 27, 2005
Last updated
Dec 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X K4680 TX Primary

Addresses

Primary practice location

1904 Pine St
Suite 4B
Abilene, TX 79601-2449

Mailing address

1904 Pine St
Suite 4B
Abilene, TX 79601-2449
Phone (325) 670-4494

Other identifiers 2

IdentifierTypeStateIssuer
1245226927OtherTXFIRST CARE
043839202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091110000016 TX Practitioner - Nephrology 6800945593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1904 Pine St
Suite 4B
Abilene, TX 79601-2450
Phone (325) 670-4494

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K4680TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abilene Kidney Clinic, P.a. Nephrology CurrentSince Oct 19, 2009 Accepting new patients
James D Webster MD & Associates Nephrology PastSince Oct 16, 2022 Accepting new patients

Locations

1850 Hickory St
Ste 105
Abilene, TX 79601
Phone (325) 660-7846

1904 Pine St
Ste 4B
Abilene, TX 79601
Phone (325) 670-4494

Organizations & group practices 2

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 6

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1245226927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 PINE ST",
            "address_2": "SUITE 4B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012449",
            "telephone_number": "325-670-4494",
            "fax_number": "325-670-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 PINE ST",
            "address_2": "SUITE 4B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012449",
            "telephone_number": "325-670-4494",
            "fax_number": "325-670-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURY",
        "first_name": "IBRAHIM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "K4680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "1245226927",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043839202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.