NPIMap

Individual provider Active NPI

Hassan Mohammad Ibrahim, M.D.

  • Cardiovascular Disease Physician
  • Sandusky, OH
National Provider Identifier
1326027442
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35069698 Issued in OH
Practice address
703 Tyler St
Suite 250
Sandusky, OH 44870-3367
Phone
(440) 414-9300
Fax
(216) 201-5588
NPI assigned
Jan 17, 2006
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35069698 OH Primary

Addresses

Primary practice location

703 Tyler St
Suite 250
Sandusky, OH 44870-3367

Mailing address

703 Tyler St Ste 250
Sandusky, OH 44870-3390
Phone (440) 414-9300

Other identifiers 6

IdentifierTypeStateIssuer
E69698OtherOHSUMMA
0221594MedicaidOH
060033301OtherRAILROAD MEDICARE
341221800055OtherOHCARESOURCE
000000128722OtherOHANTHEM
100410OtherOHKAISER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000258 OH Practitioner - Cardiovascular Disease (Cardiology) 4789581661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

125 E Broad St
Suite 218
Elyria, OH 44035-6447
Phone (440) 329-7310

158 W Main Rd
Conneaut, OH 44030-2039

29325 Health Campus Dr
Westlake, OH 44145-8201

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35069698OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Cardiovascular Disease CurrentSince Oct 1, 2021 Accepting new patients
Firelands Regional Medical Center Current Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2021 Accepting new patients
University Primary Care Practices Past Accepting new patients
North Ohio Heart Center Inc Cardiovascular Disease Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

29325 Health Campus Dr
Ste 3
Westlake, OH 44145
Phone (440) 414-9400

Interoperability endpoints

  • Direct secure messaging: hibrahim37305@ehrdirect.uhhospitals.org

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1326027442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 TYLER ST STE 250",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703390",
            "telephone_number": "440-414-9300",
            "fax_number": "216-201-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 TYLER ST",
            "address_2": "SUITE 250",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703367",
            "telephone_number": "440-414-9300",
            "fax_number": "216-201-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "HASSAN",
        "middle_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35069698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMA",
            "identifier": "E69698",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0221594",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060033301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341221800055",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000128722",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "100410",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.