Active NPI
Ibrahim M Daoud, MD
- Surgery Physician
- Hartford, CT
National Provider Identifier
1376657080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 017793
- Practice address
- 95 Woodland St FL 2
Hartford, CT 06105 - Phone
- (860) 714-6871
- Fax
- (860) 714-6888
- NPI assigned
- Aug 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 017793 | CT | Primary |
Addresses
Primary practice location
95 Woodland St FL 2
Hartford, CT 06105
Mailing address
95 Woodland St FL 2
Hartford, CT 06105-1290
Phone (860) 714-6871
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010017793CT06 | Other | CT | BCBS |
| 010017793CT09 | Other | CT | BCBS NEWINGTON |
| 2334262 | Other | CT | CIGNA |
| 3962278 | Other | CT | AETNA |
| 001177930 | Medicaid | CT | |
| 010017793CT08 | Other | CT | BCBS WETHERSFIELD |
| 202928529 | Other | CT | UNITED HEALTHCARE |
| 720239 | Other | CT | CONNECTICARE |
| 010017793CT07 | Other | CT | BCBS ROCKYHILL |
| P471096 | Other | CT | OXFORD HEALTH PLAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1376657080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 WOODLAND ST FL 2",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051290",
"telephone_number": "860-714-6871",
"fax_number": "860-714-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 WOODLAND ST FL 2",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06105",
"telephone_number": "860-714-6871",
"fax_number": "860-714-6888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAOUD",
"first_name": "IBRAHIM",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "017793",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "010017793CT06",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NEWINGTON",
"identifier": "010017793CT09",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2334262",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3962278",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001177930",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS WETHERSFIELD",
"identifier": "010017793CT08",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "202928529",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "720239",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ROCKYHILL",
"identifier": "010017793CT07",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "P471096",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.