Active NPI
Ibrahim Abu-Usbaabdel-Fattah
- General Practice Physician
- Aibonito, PR
National Provider Identifier
1285851758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 11946
- Practice address
- C Jose C Vazquez Int
Aibonito, PR 00705 - Phone
- (787) 735-7969
- NPI assigned
- Apr 19, 2007
- Last updated
- Aug 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 11946 | PR | Primary |
Addresses
Primary practice location
C Jose C Vazquez Int
Aibonito, PR 00705
Mailing address
P O Box 270161
San Juan, PR 00927
Phone (787) 735-7969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11946 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1285851758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 270161",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00927",
"telephone_number": "787-735-7969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "C JOSE C VAZQUEZ INT",
"city": "AIBONITO",
"state": "PR",
"postal_code": "00705",
"telephone_number": "787-735-7969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABU-USBAABDEL-FATTAH",
"first_name": "IBRAHIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "11946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aibonito, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.