Individual provider Active NPI

Marina Kristy Ibraheim, MD

  • Dermatology Physician
  • San Francisco, CA
National Provider Identifier
1265010995
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A182460 Issued in CA
Practice address
1701 Divisadero St # 280
San Francisco, CA 94115-3011
Phone
(415) 353-7546
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A182460 CA Primary

Addresses

Primary practice location

1701 Divisadero St # 280
San Francisco, CA 94115-3011

Mailing address

1701 Divisadero St # 280
San Francisco, CA 94115-3011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260527003203 CA Practitioner - Dermatology 0244639995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2001 The Embarcadero
Suite 1500
San Francisco, CA 94143-5200

2001 The Embarcadero St
Suite 1500
San Francisco, CA 94133-2964

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182460CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Medical Center PastSince Jun 29, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1265010995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 DIVISADERO ST # 280",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 DIVISADERO ST # 280",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153011",
            "telephone_number": "415-353-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHEIM",
        "first_name": "MARINA",
        "middle_name": "KRISTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A182460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.