Donia Ibrahim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8710 Issued in AZ

Practice address

4700 S McClintock Dr Ste 140
Tempe, AZ 85282-7375

Phone

(480) 590-0787

NPI assigned

Jun 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Advanced Minimally Invasive Surgical

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1295056919
  Medicare reassignment NPD
• Active Vital Care LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1326825092
  Medicare reassignment
• Angels Valley Community Healthcare Center PLLC

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1689303117
  Medicare reassignment
• Revive Community Health

  • Wound Care Registered Nurse
  • Tempe, AZ
  • NPI 1255916987
  Medicare reassignment
• Mavie LLC

  • Family Medicine Physician
  • La Pine, OR
  • NPI 1366270365

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1275159840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 S MCCLINTOCK DR STE 140",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827375",
            "telephone_number": "480-590-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S MCCLINTOCK DR STE 140",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827375",
            "telephone_number": "480-590-0787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 N Dodge Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857162673",
            "country_code": "US",
            "telephone_number": "480-851-6309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "DONIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006526RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyrides LLC
• Hyrum G. Hatch D.D.S., P.C.
• Jennifer Iacovo, DNP, FNP-C
• Brittany Ibanez, LPN
• Jennifer Ibarra
• Icare Health Services LLC
• Heather Marie Hodnett Igbinovia, ANP-BC, GNP-BC
• Mary O Igwenwanne
• Gregory Iiames, MAPC
• Laryssa Ikehara

• Physician Assistant in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.