Ibraheem Abbas, MD
Individual provider Active NPI Internal Medicine Physician · Fort Worth, TX
NPI 1245404649 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1245404649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- Q3624 (TX)
- Practice address
- 1301 Pennsylvania Ave
Fort Worth, TX 76104-2122 - Phone
- (817) 250-4906
- Fax
- (817) 250-1815
- NPI assigned
- Apr 16, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Texas Health Physicians Group
Practice addresses (Care Compare)
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906
Hospital & facility affiliations
- Texas Health Harris Methodist Hospital Southwest F
- Texas Health Harris Methodist Fort Worth
- Texas Health Harris Methodist Hospital Stephenvill
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150811004310 | TX | Practitioner - Internal Medicine |
2567520802 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Q3624 | TX | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Health Physicians Group | Current | Accepting new patients | |
| Texas Health Virtual Care | Current |
Accepting new patients | |
| Texas Health Physicians Group | Internal Medicine | Current |
Accepting new patients |
| Texas Health Virtual Care | Internal Medicine | Current |
Accepting new patients |
| Texas Health Physicians Group | Current |
Accepting new patients | |
| Access Telecare, PLLC | Internal Medicine | Past |
Accepting new patients |
| Texas Health Harris Methodist Hospital Fort Worth | Past | Accepting new patients | |
| Baystate Medical Practices, Inc | Internal Medicine | Past | Accepting new patients |
| Baystate Affiliated Practice Organization | Internal Medicine | Past | Accepting new patients |
Locations
1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803
4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500
8200 Walnut Hill Ln
Fl 9
Dallas, TX 75231
Phone (214) 345-8001
1300 W Terrell Ave
Ste K230
Fort Worth, TX 76104
Phone (817) 250-7240
6100 Harris Pkwy
Ft Worth, TX 76132
Phone (817) 346-5000
1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000
Interoperability endpoints
- ibraheem.abbas.1@13957.direct.athenahealth.com
- https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/
- iabbas696846@direct.texashealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Q3624 | TX | Yes |
| Nephrology Physician | 207RN0300X | Q3624 | TX |
Addresses
Primary practice location
1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Mailing address
8844 Laurel LN
Keller, TX 76248-1425
Phone (570) 423-1330
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350591010 | Medicaid | TX |
Other providers in Fort Worth, TX
- Leonel Abarca Jr
- Abba 4Ever Enterprises, Inc
- Abba Healthcare Enterprises, L.L.C.
- Abigail Leonardo Abbas
- Hibah Bushra Abbas
- Abberrymangroup LLC
- Sheri Elaine Abbey
- Vanessa Abbood
- Abbott Clinic, PA
- Jacob Clifford Abbott
All providers in Fort Worth, TX · Internal Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.