Wael S Ibrahim, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

79808 Issued in MN

Practice address

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306

Phone

(651) 633-6883

Fax

(651) 331-3459

NPI assigned

May 14, 2018

Last updated

Dec 4, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Pathology

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Tareen Dermatology PAGroup PAC ID 8123288156, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Tareen Dermatology, P.a.

  • Dermatology Physician
  • Roseville, MN
  • NPI 1063782621

  WI

  Medicare reassignment Care Compare group NPD
• Tareen Dermatology, PA

  • Non-Pharmacy Dispensing Site
  • Maplewood, MN
  • NPI 1851856504
  NPD (past)

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1376033563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-633-6883",
            "fax_number": "651-331-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "651-633-6883",
            "fax_number": "651-331-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "WAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MN",
            "license": "79808",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "WI",
            "license": "85806-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eva Igler, PHD
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• Dermatopathology (Pathology) Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Dermatopathology (Pathology) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.