Hassan M Ebrahim, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

ME 103579 Issued in FL

Practice address

200 Avenue F NE
Winter Haven, FL 33881-4131

Phone

(863) 292-4670

Fax

(863) 292-4671

NPI assigned

Sep 29, 2006

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Hematology/OncologyAlso: Internal Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282
• Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
• Bartow Regional Medical Center Hospital, Bartow, FL, CCN 100121

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: hassan.ebrahim@direct.mybaycare.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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD
• Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1679724488
  NPD (past)
• Newco Cancer Services, LLC

  • Radiation Oncology Physician
  • Greenville, NC
  • NPI 1528375052

  Hematology & Oncology

  NPD (past)

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

• Bartow Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Bartow, FL
  • NPI 1558734095
  Care Compare affiliation
• Baycare Home Care, Inc.

  • Home Health Agency
  • Bradenton, FL
  • NPI 1295728186
  Care Compare affiliation
• Baycare Home Care, Inc.

  • Home Health Agency
  • Lakeland, FL
  • NPI 1952309171
  Care Compare affiliation
• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Care Compare affiliation

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1306938774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NORTHEAST",
            "address_2": "CANCER CTR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33881",
            "telephone_number": "863-292-4670",
            "fax_number": "863-292-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-292-4670",
            "fax_number": "863-292-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "HASSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-04-07",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 103579",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2013-00226",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME 103579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2239",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "180AA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306938774",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hassan.ebrahim@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hematology & Oncology Physician in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.