Individual provider Active NPI

Farhan Ibrahimi, MD

  • Internal Medicine Physician
  • Northborough, MA
National Provider Identifier
1275688442
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236049 Issued in MA
Practice address
10,010 K Shops Way
Northborough, MA 01532
Phone
(508) 936-3866
NPI assigned
Jan 25, 2007
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 236049 MA Primary

Addresses

Primary practice location

10,010 K Shops Way
Northborough, MA 01532

Mailing address

1215 Broadway
Raynham, MA 02767-1942
Phone (508) 894-0400

Other identifiers 1

IdentifierTypeStateIssuer
236049OtherMAMASSACHUSSETTS MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081024000206 MA Practitioner - Internal Medicine 6305819657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

24 Newton St
Southborough, MA 01772-1215
Phone (508) 486-4472

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Nov 20, 2023 Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

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 4

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1275688442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 BROADWAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671942",
            "telephone_number": "508-894-0400",
            "fax_number": "508-565-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10,010 K SHOPS WAY",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "01532",
            "telephone_number": "508-936-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIMI",
        "first_name": "FARHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "236049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSSETTS MEDICAL LICENSE",
            "identifier": "236049",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

Verify at the official NPI Registry.