Active NPI
Jamil Ibrahim
- Nephrology Physician
- Brooklyn, NY
National Provider Identifier
1306267745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 1306267745
- Practice address
- 3857 Kings Hwy
Apt 6B
Brooklyn, NY 11234-2943 - Phone
- (917) 775-4830
- NPI assigned
- Jan 3, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 285503 | NY | |
| Nephrology Physician | 207RN0300X | 1306267745 | NY | Primary |
Addresses
Primary practice location
3857 Kings Hwy
Apt 6B
Brooklyn, NY 11234-2943
Mailing address
3857 Kings Hwy
Apt 6B
Brooklyn, NY 11234
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1306267745 | NY | MD | Nephrology Physician |
Interoperability endpoints
- jibrahim19242@sbhny.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1306267745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 KINGS HWY",
"address_2": "APT 6B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 KINGS HWY",
"address_2": "APT 6B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112342943",
"telephone_number": "917-775-4830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "JAMIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-03",
"last_updated": "2024-04-15",
"certification_date": "2024-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "285503",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NY",
"license": "1306267745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.