Elmoataz Ibrahim, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4301094678 Issued in 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

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Neurology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Mymichigan Medical Center SaginawGroup PAC ID 6305737156, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Saginaw Hospital, Saginaw, MI, CCN 230077
• Memorial Healthcare Hospital, Owosso, MI, CCN 230121
• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eibrahim14269@direct.hfhs.org

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.

• Memorial Hospital

  dba Memorial Medical Associates

  • General Practice Physician
  • Owosso, MI
  • NPI 1235160532

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Mymichigan Medical Center Saginaw

  dba Ascension Medical Group Neurosurgery

  • Neurological Surgery Physician
  • Saginaw, MI
  • NPI 1285974014
  Medicare reassignment Care Compare group NPD
• Covenant Medical Center, Inc.

  dba Covenant HealthCare

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment NPD
• Manaf Seid-Arabi, M.D. P.C.

  • Neurology Physician
  • Clinton Township, MI
  • NPI 1487605101
  Medicare reassignment NPD
• E.I. Neurology Associates, PLLC

  • Neurology Physician
  • Clinton Township, MI
  • NPI 1245734730
  NPD Authorized official
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376

  Internal Medicine

  NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • General Practice Physician
  • Owosso, MI
  • NPI 1316008006

  Neurology

  NPD
• Memorial Hospital

  dba Memorial Medical Associates

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD
• Mymichigan Medical Center Saginaw

  dba Ascension Medical Group Neurology Partners

  • Neurology Physician
  • Saginaw, MI
  • NPI 1366063729
  NPD
• Mymichigan Medical Center Saginaw

  dba Ascension Medical Group Riverfront Cardiology

  • Cardiovascular Disease Physician
  • Saginaw, MI
  • NPI 1467736132
  NPD
• Mymichigan Medical Center Saginaw

  dba Ascension Medical Group Heritage Family Physicians

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1518042530
  NPD
• Memorial Hospital

  dba Memorial Healthcare

  • Home Health Agency
  • Owosso, MI
  • NPI 1952498610
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital

  dba Memorial Healthcare

  • General Acute Care Hospital
  • Owosso, MI
  • NPI 1063414233
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  dba Family Practice Center

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation
• Mymichigan Medical Center Saginaw

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1871507509
  Care Compare affiliation

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1285883371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43781 STONEY LN",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132259",
            "telephone_number": "586-263-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381147",
            "telephone_number": "586-263-0610",
            "fax_number": "586-263-0834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29984 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480341355",
            "country_code": "US",
            "telephone_number": "248-357-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "ELMOATAZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-12",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094678",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57-014393",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301094678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Hyso
• Larisa Iacoban
• Davide Iacobelli, MD
• Angela K Ianitelli, PA-C
• Andy Ibrahim
• Icare Counseling of Michigan, PLLC
• Jill Ann Idicula
• Kenneth Michael Ierardi, DO
• Luiza Fernandes Iervolino Lemerise, PT, DPT.
• Elizabeth Ignace, LLMSW

• Neurology Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.