Elmoataz Ibrahim, M.D.
Individual provider Active NPI Neurology Physician · Clinton Township, MI
NPI 1285883371 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1285883371
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 4301094678 (MI)
- Practice address
- 15945 19 Mile Rd
Clinton Township, MI 48038-1147 - Phone
- (586) 263-0610
- Fax
- (586) 263-0834
- NPI assigned
- Sep 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 23
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital
Mymichigan Medical Center Saginaw
Practice addresses (Care Compare)
3337 Britton Rd
Perry, MI 48872-9706
Phone (517) 625-3004
4200 Fashion Square Blvd
Suite 301
Saginaw, MI 48603-1375
Phone (989) 729-4206
800 S Washington Ave
Saginaw, MI 48601-2551
Phone (855) 298-9888
Hospital & facility affiliations
- Mymichigan Medical Center Saginaw
- Memorial Healthcare
- Mymichigan Medical Center Midland
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20110927000032 | MI | Practitioner - Neurology |
2163693060 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57-014393 | OH | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Saginaw | Current |
Accepting new patients | |
| E.I. Neurology Associates, PLLC | Neurology | Current |
Accepting new patients |
| Memorial Hospital | Current |
Accepting new patients | |
| Covenant Medical Center, Inc | Internal Medicine | Current |
Accepting new patients |
| Memorial Hospital | Internal Medicine | Current | Accepting new patients |
| Covenant Medical Center, Inc. | Current | Accepting new patients | |
| Memorial Hospital | Neurology | Current |
Accepting new patients |
| Mymichigan Medical Center Saginaw | Neurology | Current |
Accepting new patients |
| Manaf Seid-Arabi, M.D. P.C. | Neurology | Current |
Accepting new patients |
| Mymichigan Medical Center Saginaw | Current | Accepting new patients | |
| Mymichigan Medical Center Saginaw | Current | Accepting new patients | |
| Michigan Medical Clinics, Inc | Past | Accepting new patients | |
| Memorial Hospital | Past | Accepting new patients |
Locations
9900 Birch Run Rd
Ste D
Birch Run, MI 48415
Phone (989) 624-1575
9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273
15945 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 267-2468
15945 19 Mile Rd
Ste 106
Clinton Twp, MI 48038
Phone (586) 263-0610
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
819 N Shiawassee St
Ste 110
Owosso, MI 48867
Phone (989) 723-1390
3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004
700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000
3570 Shattuck Rd
Saginaw, MI 48603
Phone (989) 792-5353
1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220
4200 Fashion Square Blvd
Ste 301
Saginaw, MI 48603
Phone (989) 729-4206
800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000
800 Cooper Ave
Ste 11
Saginaw, MI 48602
Phone (989) 583-7090
Interoperability endpoints
- eibrahim14269@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301094678 | MI | |
| Critical Access Hospital | 282NC0060X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | 57-014393 | OH | |
| Neurology Physician | 2084N0400X | 4301094678 | MI | Yes |
Addresses
Primary practice location
15945 19 Mile Rd
Clinton Township, MI 48038-1147
Mailing address
43781 Stoney LN
Sterling Heights, MI 48313-2259
Phone (586) 263-0610
Other practice location 1
29984 Telegraph Rd
Southfield, MI 48034-1355
Phone (248) 357-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-4754278 | Other | MI | E.I. NEUROLOGY ASSOCIATES PLLC |
Other providers in Clinton Township, MI
- Shannon Hyso
- Larisa Iacoban
- Davide Iacobelli
- Angela K Ianitelli
- Andy Ibrahim
- Icare Counseling of Michigan, PLLC
- Jill Ann Idicula
- Kenneth Michael Ierardi
- Luiza Fernandes Iervolino Lemerise
- Elizabeth Ignace
All providers in Clinton Township, MI · Neurology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. 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.